A large number of people are bitten by dogs—approximately 19 in every 1000 people in the UK per year with even higher proportions in France and the United States. Co-amoxiclav is the most effective antibiotic treatment following a dog bite as it covers the most likely polymicrobial aerobic and anaerobic organisms that infect dog bite wounds (Staphylococci, Streptococci and Pasteurella). Pasteurella is the most infective pathogen in a dog bite so effective antibiotic treatment against it is essential to prevent a metastatic infection. This article explores the normal physiology of human skin including the pathophysiology after sustaining a dog bite. It also examines the pharmacology of co-amoxiclav including critically reviewing the current evidence for the effectiveness of its use in this field as a first-line and prophylactic oral antibiotic treatment.

Marc Gildas Thomas -