Hesperian Health Guides
Medicines for Animal Bites
Amoxicillin with clavulanic acid is the best choice for treating
animal bites.
If you do not have amoxicillin with clavulanic acid, use 2 antibiotics: Give one of these: doxycycline, cotrimoxazole, or penicillin V
AND one of these: metronidazole or clindamycin
If the bite was from a dog, a bat, or another animal that could have rabies, also give a rabies vaccine and rabies immunoglobulin if needed (see below).
Rabies vaccine and rabies immunoglobulin
Where there are animals with rabies, any animal bite or scratch breaking the skin will need thorough cleaning with soap and water for at least 15 minutes, a series of rabies vaccine injections, and, if the rabies risk is high, also an injection of rabies immunoglobulin. Even if there is no rabies immunoglobulin available, washing the skin very well right away and giving the series of rabies vaccine can prevent rabies.
Using rabies vaccine
Inject the complete vial of vaccine (either 0.5 ml or 1 ml depending on the vaccine manufacturer) into the upper arm muscle on the day of the bite, and then again on days 3, and 7. Then, a fourth injection is given between day 14 (2 weeks) and 28 (4 weeks) after the bite. For a child 2 years or younger, give injections in the upper thigh (not the buttock).
When giving rabies immunoglobulin, also give rabies vaccine, but use a different clean needle and inject in a different place on the body.
Using rabies immunoglobulin
There are two forms of rabies immunoglobulin, one made from human serum (HRIG) and one made from horse serum (ERIG). HRIG is safer.
Rabies immunoglobulin can cause a severe allergic reaction for some people. Always have epinephrine (adrenaline) available in case of an allergic reaction.
Inject rabies immunoglobulin in and around the cleaned wound.
If there are several wounds and the amount of rabies immunoglobulin you have is not enough to inject into each one, add buffered saline solution to double the amount of liquid. Then the person will still receive the correct dose and all wounds will receive some medicine.
If using Human Rabies Immune Globulin (HRIG),
If using Equine Rabies Immune Globulin (ERIG),