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August 21, 1981

Prophylactic Antibiotics and Dog Bite Wounds

JAMA. 1981;246(8):833-834. doi:10.1001/jama.1981.03320080019008

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To the Editor.—  Regarding the concise review of the management of dog bite injuries by Michael Callaham, MD (1980;244:2327), he has nicely summarized many important aspects of the appropriate treatment of these common wounds. We would, however, like to offer a different opinion of the use of prophylactic antibiotics in their care.We recently completed a prospective, double-blind, placebo-controlled study designed to determine the value of prophylactic oxacillin administration in the treatment of dog bite wounds. Adult patients having uninfected, full-thickness wounds seen within 24 hours of injury were considered for inclusion. Patients requiring hospitalization, having open fractures, already receiving antibiotics for some other medical problem, or stating an allergy to penicillin were excluded. Emergency department management consisted of cleansing, irrigation, debridement, and closure as indicated; no topical antibiotics were applied. Patients were initially classified as having all open or one or more closed wounds and then randomly assigned to receive eithers