Animal bites

Last updated: October 19, 2023

Summarytoggle arrow icon

Bite wounds can result in physical trauma, bacterial infection, virus transmission, and in some cases, envenomation. The general management of bite wounds involves assessment of the wound, acute wound management, and prophylaxis to prevent infections (e.g., rabies postexposure prophylaxis, tetanus prophylaxis, antibiotic prophylaxis). More specific therapy is based on the location of the wound and the animal that inflicted the wound. Depending on the severity and location of the injury, specialist management may be necessary, e.g., ophthalmology for wounds involving the eye or eyelid.

This article focuses on the bites of nonvenomous animals; see “Envenomation” for more specific information on venomous animals.

Overviewtoggle arrow icon

Overview of bite wound management [2][3]
Appropriate for primary wound closure Antibiotic prophylaxis for bite wounds Rabies PEP PEP for other body fluid and bloodborne pathogens
Human bites
  • Yes
  • No
Canine bites
  • Uninfected facial wounds < 24 hours
  • Most other uninfected wounds < 12 hours except hand or foot wounds
  • No
Cat bites
  • Yes
Rodent bites *
  • Uninfected facial wounds < 24 hours
  • Most other uninfected wounds < 12 hours
  • No
  • No
Bat bites *
  • Uninfected facial wounds < 24 hours
  • Most other uninfected wounds < 12 hours
  • No
  • Yes
Monkey bites
  • Yes

Primary wound closure is usually inappropriate for hand and foot bite wounds because of the greater risk of infection. [3]

Human and animal rabies are notifiable diseases.

Management of bite woundstoggle arrow icon


Follow local public health protocols as mandatory reporting requirements for animal bites vary regionally.


Wound care

Risk of infection from animal bites [3]



Nonfacial wound age < 12 hours > 12 hours
Facial wound age < 24 hours > 24 hours
Hand or foot involvement No Yes
Canine or rodent bite Yes No
Signs of infection No Yes

Antibiotics for bite wounds

Approach [5]

  • Prophylaxis
  • Treatment

Obtain both aerobic and anaerobic cultures to guide the treatment of infected bite wounds. [5][6]

Preferred agents [1][6][7][8]

Alternative agents [1][6][7][8]

Additional prophylaxis [2]

Foxes, skunks, raccoons, and bats are the main reservoir species for rabies in the US, but all mammals are susceptible. [9]


Complications of bite wounds [2]

Human bitestoggle arrow icon

Transmissible bacteria

Clinical features [2]

Signs of wound infection are common as there is often a delay before patients seek health care for human bites.

Maintain a high degree of suspicion for a clenched-fist injury in dorsal hand lacerations as patients may not initially disclose involvement in an altercation. [2]

Management [2][10][11]

Human bites carry a high risk of polymicrobial infection by organisms such as Staphylococcus spp., Streptococcus spp., Corynebacterium spp., Fusobacterium spp., and Eikenella corrodens. [2]

Consider screening for sexual violence, intimate partner violence, or child maltreatment in at-risk patients with human occlusive bite wounds. [2]


Canine bitestoggle arrow icon

Canines include domestic dogs, foxes, coyotes, and wolves.

Although dog bites are the leading cause of rabies transmission worldwide, the risk of contracting rabies from domestic dogs in the US is low. [14]

Cat bitestoggle arrow icon

Provide antibiotic prophylaxis for bite wounds (e.g., amoxicillin-clavulanate) with coverage for cat-specific flora (e.g., Pasteurella multocida) because of the high infection rate of cat bites.

Rodent bitestoggle arrow icon

Rodents include mice, rats, hamsters, guinea pigs, squirrels, and beavers.

Rodents are rarely found to have rabies and have not been known to transmit rabies to humans. [17]

Bat bitestoggle arrow icon

Any direct contact with a bat (e.g., touch, bite, or scratch) may transmit rabies. [14]

Monkey bitestoggle arrow icon

Shark bitestoggle arrow icon

  • Examples: great white shark, tiger shark, bull shark
  • Epidemiology
    • Despite posing a relatively low public health risk, shark-related injuries often generate disproportionately great public and media attention.
    • Annually, 70–80 unprovoked shark attacks occur worldwide [22]
  • Management

Approx. 7% of shark attacks are fatal. [23]

Referencestoggle arrow icon

  1. Walls R, Hockberger R, Gausche-Hill M, Erickson TB, Wilcox SR. Rosen's Emergency Medicine 10th edition- Concepts and Clinical Practice E-Book. Elsevier Health Sciences ; 2022
  2. Holmes GP, Chapman LE, Stewart JA, et al. Guidelines for the Prevention and Treatment of B-Virus Infections in Exposed Persons. Clin Infect Dis. 1995; 20 (2): p.421-439.doi: 10.1093/clinids/20.2.421 . | Open in Read by QxMD
  3. Jeffrey I. Cohen, David S. Davenport, John A. Stewart, Scott Deitchman, Julia K. Hilliard, Louisa E. Chapman. Recommendations for Prevention of and Therapy for Exposure to B Virus (<i>Cercopithecine Herpesvirus</i>1). Clinical Infectious Diseases. 2002; 35 (10): p.1191-1203.doi: 10.1086/344754 . | Open in Read by QxMD
  4. Brook I. Management of human and animal bite wound infection: An overview. Curr Infect Dis Rep. 2009; 11 (5): p.389-395.doi: 10.1007/s11908-009-0055-x . | Open in Read by QxMD
  5. Bhaumik S, Kirubakaran R, Chaudhuri S. ​Primary closure versus delayed or no closure for traumatic wounds due to mammalian bite. Cochrane Database Syst Rev. 2019.doi: 10.1002/14651858.cd011822.pub2 . | Open in Read by QxMD
  6. Dato VM, Campagnolo ER, Long J, Rupprecht CE. A Systematic Review of Human Bat Rabies Virus Variant Cases: Evaluating Unprotected Physical Contact with Claws and Teeth in Support of Accurate Risk Assessments. PLoS ONE. 2016; 11 (7): p.e0159443.doi: 10.1371/journal.pone.0159443 . | Open in Read by QxMD
  7. Pounder D. Avoiding rabies. BMJ. 2005; 331 (7515): p.469-470.doi: 10.1136/bmj.331.7515.469 . | Open in Read by QxMD
  8. Manning SE, Rupprecht CE, Fishbein D, et al. Human rabies prevention--United States, 2008: recommendations of the Advisory Committee on Immunization Practices.. MMWR Recomm Rep. 2008; 57 (RR-3): p.1-28.
  9. Looke D, Dendle C. Bites (Mammalian). BMJ Clin Evid. 2010; 2010.
  10. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014; 59 (2): p.e10-52.doi: 10.1093/cid/ciu444 . | Open in Read by QxMD
  11. Greene SE, Fritz SA. Infectious Complications of Bite Injuries. Infect Dis Clin North Am. 2021; 35 (1): p.219-236.doi: 10.1016/j.idc.2020.10.005 . | Open in Read by QxMD
  12. Woodring JH, Reed JC. Types and mechanisms of pulmonary atelectasis. J Thorac Imaging. 1996; 11 (2): p.92-108.
  13. Weber DJ, Hansen AR. Infections Resulting from Animal Bites. Infect Dis Clin North Am. 1991; 5 (3): p.663-680.doi: 10.1016/s0891-5520(20)30413-x . | Open in Read by QxMD
  14. Warrell MJ, Warrell DA. Rabies: the clinical features, management and prevention of the classic zoonosis. Clin Med. 2015; 15 (1): p.78-81.doi: 10.7861/clinmedicine.14-6-78 . | Open in Read by QxMD
  15. Kennedy SA, Stoll LE, Lauder AS. Human and Other Mammalian Bite Injuries of the Hand. J Am Acad Orthop Surg. 2015; 23 (1): p.47-57.doi: 10.5435/jaaos-23-01-47 . | Open in Read by QxMD
  16. Panchabhai T, Patil P, Galwankar S. Managing human bites. J Emerg Trauma Shock. 2009; 2 (3): p.186.doi: 10.4103/0974-2700.55331 . | Open in Read by QxMD
  17. ISAF - Yearly Worldwide Shark Attack Summary. Updated: January 24, 2022. Accessed: February 8, 2022.
  18. International shark attack file. Updated: February 2, 2018. Accessed: February 8, 2022.
  19. Ellis R, Ellis C. Dog and cat bites.. Am Fam Physician. 2014; 90 (4): p.239-43.
  20. Abrahamian FM, Goldstein EJC. Microbiology of Animal Bite Wound Infections. Clin Microbiol Rev. 2011; 24 (2): p.231-246.doi: 10.1128/cmr.00041-10 . | Open in Read by QxMD
  21. Savu AN, Schoenbrunner AR, Politi R, Janis JE. Practical Review of the Management of Animal Bites.. Plastic and reconstructive surgery. Global open. 2021; 9 (9): p.e3778.doi: 10.1097/GOX.0000000000003778 . | Open in Read by QxMD
  22. Sean P. Elliott. Rat Bite Fever and <i>Streptobacillus moniliformis</i>. Clin Microbiol Rev. 2007; 20 (1): p.13-22.doi: 10.1128/cmr.00016-06 . | Open in Read by QxMD
  23. Fitzpatrick JL, Dyer JL, Blanton JD, Kuzmin IV, Rupprecht CE. Rabies in rodents and lagomorphs in the United States, 1995–2010. J Am Vet Med Assoc. 2014; 245 (3): p.333-337.doi: 10.2460/javma.245.3.333 . | Open in Read by QxMD

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