Dog bites in children: epidemiology, microbiology, and penicillin prophylactic therapy.
Fifty-five children with nonfacial dog bites were prospectively studied. Patients were assigned to an experimental group receiving oral penicillin or a control group receiving local wound care only. Wounds were cultured for anaerobic and aerobic flora prior to cleansing. Results showed that most children were bitten on an extremity by a familiar dog, sustained simple injuries, and sought prompt medical attention. The overall infection rate was 3.6%, with one patient in each group developing an infection. The most frequently recovered organisms were normal skin flora. No Pasteurella multocida were isolated. Forty percent of cultures yielded potential pathogens. Despite this finding, initial cultures of dog bite wounds had no value in predicting subsequent infection. This study suggests that routine use of prophylactic penicillin is not required for simple nonfacial dog bites in children.
There is no direct evidence that educational programmes can reduce dog bite rates in children and adolescents. Educating children who are less than 10 years old in school settings could improve their knowledge, attitude and behaviour towards dogs. Educating children and adolescents in settings other than schools should also be evaluated. There is a need for high quality studies that measure dog bite rates as an outcome. To date, evidence does not suggest that educating children and adolescents is effective as a unique public health strategy to reduce dog bite injuries and their consequences.