David Looke1, Claire Dendle. 1. Department of Medicine, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia.
Abstract
INTRODUCTION: Mammalian bites are usually caused by dogs, cats, or humans, and are more prevalent in children (especially boys) than in adults. Animal bites are usually caused by the person's pet and, in children, frequently involve the face. Human bites tend to occur in children as a result of playing or fighting, while in adults they are usually the result of physical or sexual abuse. Mixed aerobe and anaerobe infection is the most common type of infection, and can occur in up to half of human bites. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent complications of mammalian bites? What are the effects of treatments for infected mammalian bites? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found five systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotic prophylaxis (human bites, non-human bites), antibiotics, debridement, decontamination, irrigation, primary wound closure, and tetanus vaccination (after mammalian bites).
INTRODUCTION:Mammalian bites are usually caused by dogs, cats, or humans, and are more prevalent in children (especially boys) than in adults. Animal bites are usually caused by the person's pet and, in children, frequently involve the face. Human bites tend to occur in children as a result of playing or fighting, while in adults they are usually the result of physical or sexual abuse. Mixed aerobe and anaerobe infection is the most common type of infection, and can occur in up to half of human bites. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent complications of mammalian bites? What are the effects of treatments for infected mammalian bites? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found five systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotic prophylaxis (human bites, non-human bites), antibiotics, debridement, decontamination, irrigation, primary wound closure, and tetanus vaccination (after mammalian bites).