Wounds & Surgical SIte Infections
Antibiotics are not indicated for:
- Cat bite abscess (unless surrounding cellulitis or pyrexia)
- Cutaneous surgical site dehiscence without gross evidence of systemic or surgical site infection (SSI)
- Acute superficial traumatic wounds
- Snake bites
Bites & Traumatic Wounds
Decontaminate and debride (lavage ± surgical debridement ± use
of dressings)
If systemically well and not pyrexic
- Wound lavage with isotonic solution (e.g. saline)
If wound located over abdomen or thorax
- Further investigation (imaging) ± surgical exploration may be required
If systemically unwell OR pyrexic OR suspicion of cavity penetration
- Cefuroxime ± cefalexin
- Amoxicillin/clavulanate
Acute bite wound prophylaxis
- Thorough flushing with saline + open wound management
- Systemic antibiotics not required if affected region is superficial and localized
- Amoxicillin/clavulanate (for 1–3 days or until tissues declared viable) if bite at critical site
Superficial Surgical Site Infections:
Topical treatment ONLY
- Frequent saline lavage
Deep Surgical Site Infections:
If systemically unwell OR pyrexic OR local cellulitis/purulent discharge from deep incision
- Cefuroxime OR cefalexin
- Amoxicillin/clavulanate
If rods are seen on cytology, or prior antibiotic courses
- Consider ADDING fluoroquinolone
If there is a history of MRSP/MRSA
Await susceptibility testing and assess clinical response before adapting treatment
Treat for 1–2 weeks guided by clinical progression
