Best antiseptic for dog bite wounds to reduce antibiotics use

Abstract

Therapy of dog bite wounds often includes empirical usage of antibiotics. This prospective clinical study aimed to compare the efficacy of polyhexanide and hypochlorous acid in reducing bacterial wound bio-burden and preventing the necessity for prophylactic antibiotics and to monitor the prevalence of multidrug- resistant bacteria. Thirty-four dogs with 51 bite wounds were randomly assigned to one of the treatment groups. Wounds were surgically debrided and treated with polyhexanide or hypochlorous acid. Swabs for culturing were taken three times: before and directly after debridement and directly after lavage. Veterinary patients were further divided into post-surgery care with and without prophylactic antibiotics. Wound healing until suture removal was monitored. Data were analyzed using a generalized linear model for ordinal data. Positive bacterial culture results after the first swab were obtained in 82.4 % wounds. Staphylococcus pseudintermedius was overrepresented in wounds, which later on developed complications. Neisseria species and streptococci species were overrepresented in cases of delayed wound closure. In 41.2 % of wounds multi-drug resistant bacteria could be detected. No negative effect of occurrence of multi-drug resistant bacteria on wound healing was observed. None of the compared antiseptics showed a significantly better wound decontamination. No superior antiseptic was found for wound lavage. Hypochlorous acid-based antiseptics provide the practical advantage of a shorter contact time. Prophylactic antibiotics should always be considered in severe dog bite wounds and might not be needed in low grade bite wounds.