A prospective, randomized study was undertaken to determine if mechanical care of early
human bites alone is sufficient
therapy in the compliant patient or if prophylactic
antibiotics (oral versus parenteral) are indicated. Beginning in June of 1985, patients presenting with
human bites of the hand were entered into the study if (1) the
bite was less than 24 hours old, (2) the patient was free of
infection, (3) the
bite did not penetrate the joint capsule, and (4) there was no injury to tendon. Forty-eight patients were ultimately segregated into one of three study groups after standardized ER mechanical
wound care. Fifteen patients received an oral placebo, with 7 developing
infection (46.7 percent). Sixteen patients received an oral
antibiotic, and 17 patients received parenteral
antibiotics. No
infections were found in either of these latter groups. The results statistically substantiate that mechanical
wound care alone is insufficient
therapy. Oral
antibiotics appear to be equal to intravenous
antibiotics for prophylaxis. From a cost-benefit standpoint, vigorous cleaning,
debridement, and coverage with a broad-spectrum oral
antibiotic are adequate care for an uncomplicated
bite in the compliant patient.