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Dog Bite Management: Rabies Risk, Wound Care, and Post-Exposure Prophylaxis

Immediate Steps

  1. Wash wound thoroughly: soap + running water 15 min.
  2. Apply antiseptic (povidone-iodine, chlorhexidine).
  3. Control bleeding; do not suture primarily (high infection risk) unless facial/gaping.
  4. Assess tetanus status (booster if >5 yr or unknown).
  5. Antibiotics: amoxicillin-clavulanate 3–5 days (prophylactic for moderate/severe bites).

Rabies Post-Exposure Prophylaxis (PEP)

ScenarioRegimen
Previously vaccinated2 doses vaccine (Day 0, 3); no RIG
Not vaccinated4 doses vaccine (Day 0, 3, 7, 14) + HRIG 20 IU/kg infiltrated around wound (Day 0)
Immunocompromised5 doses vaccine (Day 0, 3, 7, 14, 28) + HRIG

Dog Observation/Testing

  • Healthy dog/cat/ferret: 10-day observation. If remains healthy → no rabies risk.
  • Wild/unvaccinated/ill animal: euthanize + test brain (DFA).
  • Bat exposure: often no visible bite; PEP recommended if contact cannot be excluded.

Key Points

  • Rabies is nearly 100% fatal once symptomatic; PEP is 100% effective if given promptly.
  • Dog vaccination reduces but does not eliminate risk (vaccine failure, incubation period).
  • Report bite to animal control/public health.

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