Antibiotic prescribing in patients who presented to the emergency department with dog bites: A descriptive review of current practice

Megan Baxter, Kerina J. Denny, Gerben Keijzers*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: 

To describe the current practice of prophylactic antibiotic prescribing for patients presenting to the ED with a dog bite, and compare management against existing guidelines. 

Methods: 

We performed a descriptive retrospective study on all consecutive patients who presented to one tertiary teaching hospital and one regional district hospital in Southeast Queensland between 1 July 2017 and 30 June 2018 with a presentation of a dog bite. Data on demographics and management were collected from the electronic medical record using a standardised data collection tool. Risk factors supporting prophylaxis were taken from the electronic Therapeutic Guidelines. 

Results: 

Of the 336 patients included for analysis, 299 received antibiotics, of which 23 were for established infection. A total of 276 (82% of overall cohort) received a prescription for prophylactic antibiotics, either in hospital (ED or admitting ward) and/or on discharge. Of the 178 patients who received prophylactic antibiotics in hospital, 91 (51.1%) received intravenous antibiotics. Of the patients who presented to ED without a previously established infection 271 (86.6%) received prophylactic antibiotics on discharge. Over one quarter (27.5%) of patients who were given prophylactic antibiotics did not meet any high-risk factors as outlined in guidelines. 

Conclusion: 

Prophylactic antibiotics are extensively used for patients with dog bites. There is scope to rationalise antibiotic use and route of antibiotic administration in patients with dog bites.

Original languageEnglish
Pages (from-to)578-585
Number of pages8
JournalEMA - Emergency Medicine Australasia
Volume32
Issue number4
Early online date20 Jan 2020
DOIs
Publication statusPublished - 1 Aug 2020

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