S01.0-9/S11.0-2/S11.7-9/S21.0-2/S21.7-9/S31.0-5/S31.7-8/S41.0-1/S41.7-8/S51.0/S51.7-9/S61.0-1/S61.7-9/S71.0-1/S71.7-8/S81.0/S81.7-9/S91.0-3/S91.7/T01.0-3/T01.6/T01.8-9/T09.1/T11.1/T13.1/T14.0-1 + External Cause Code (W,X,Y,Z)
DESCRIPTION
Human bites may be accidental or intentional (form of assault).
Human bites may result in:
- Wound infection, often due to mixed aerobic and anaerobic infection
- Puncture wounds
- Tissue necrosis
- Transmission of diseases, e.g. HIV, hepatitis.
MEDICINE TREATMENT
Wound management:
Wash wound thoroughly with soap under running water for 5–10 minutes.
- Chlorhexidine 0.05%, solution.
Apply disinfectant if available:
- Povidone-iodine 10%, solution.
CAUTION
Do not suture bite wounds unless on the head/face. Clean thoroughly, dress (avoid compressive dressings). Review after 48 hours for secondary closure at that time.
Tetanus prophylaxis: Z23.5
If not previously immunised within the last 5 years:
- Tetanus toxoid (TT), IM, 0.5 mL.
Antibiotic treatment:
Children
- Amoxicillin/clavulanic acid oral, 15–25 mg/kg/dose of amoxicillin component, 8 hourly for 5 days.
| Use one of the following | |||||
|
Weight kg |
Dose mg (amoxicillin component) |
Susp 125/31.5 mg/5 mL |
Susp 250/62.5 mg/5 mL |
Tablet 500/125 mg/tab |
Age months/years |
| >3.5–5kg | 75 mg | 3 mL | 1.5 mL | – | >1–3 months |
| >5–7 kg | 100 mg | 4 mL | 2mL | – | >3–6 months |
| >7–9 kg | 150 mg | 6 mL | 3 mL | – | >6–12 months |
| >9–11 kg | 200 mg | 8 mL | 4 mL | – | >12–18 months |
| >11–14 kg | 250 mg | 10 mL | 5 mL | – | >18 months–3 years |
| >14–17.5 kg | 300 mg | 12 mL | 6 mL | – | >3–5 years |
| >17.5–25 kg | 375 mg | 15 mL | 7.5 mL | – | >5–7 years |
| >25–35 kg | 500 mg | 20 mL | 10 mL | 1 tablet | >7–11 years |
Children > 35 kg and adults
- Amoxicillin/clavulanic acid, oral, 875/125 mg 12 hourly for 5 days.
Severe Penicillin allergy: (Z88.0)
Children
- Macrolide, e.g.
- Azithromycin, oral, 10 mg/kg daily for 3 days See See paediatric dosing tool.
AND
- Metronidazole, oral, 7.5 mg/kg/dose 8 hourly for 5 days. See See paediatric dosing tool.
Children > 35 kg and adults
- Macrolide, e.g.:
- Azithromycin, oral, 500 mg daily for 3 days.
AND
- Metronidazole, oral, 400 mg, 8 hourly for 5 days
Hepatitis B prophylaxis (if bite is severe enough to cause bleeding): Z29.8
See Post exposure prophylaxis,
REFERRAL
- Deep and large wounds requiring suturing.
- Shock and bleeding.
- Severe infected wounds or infected wounds not responding to oral antibiotics.
- Hand bites.