Bites (Antimicrobial) | Right Decisions

Right Decisions
TAM (Treatments and Medicines) NHS Highland
ADULT THERAPEUTIC GUIDELINES
ANTIMICROBIAL GUIDANCE
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Skin & soft tissue (Antimicrobial)
Bites (Antimicrobial)

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

DO NOT SUTURE BITE WOUNDS

Antibiotic prophylaxis is advised if:

skin is broken and drawn blood
OR if skin is broken and age over 50 years, cat bite/puncture wound, bite to hand, foot, face, joint, tendon, ligament
immunocompromised /diabetic / asplenic /cirrhotic /presence of prosthetic valve or prosthetic joint.

Assess:

rabies risk (animal bite)
risk of blood borne virus transmission (human or primate bite).

Consider:

hepatitis B vaccination.

If clinically infected:

send pus or deep swab for culture before cleaning.

Drug details

Prophylaxis or treatment

Co-amoxiclav 625mg three times daily

Prophylaxis: 3 days

Treatment: 5 days

In penicillin allergy

Doxycycline 100mg twice daily PLUS metronidazole 400mg three times daily

Prophylaxis: 3 days

Treatment: 5 days

If doxycycline unsuitable

Co-trimoxazole 960mg twice daily PLUS metronidazole 400mg three times daily

Prophylaxis: 3 days

Treatment: 5 days

Last reviewed: 27/06/2024

Next review date: 27/06/2027

Author(s): Antimicrobial Management Team.

Version: 2

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Alison Macdonald, Area Antimicrobial Pharmacist.

Document Id: AMT162