ANTIBIOTICS TO PREVENT INFECTION IN PATIENTS WITH DOG-BITE WOUNDS - AMETAANALYSIS OF RANDOMIZED TRIALS

Study objectives: To determine whether prophylactic antibiotics preven t infection in patients with dog bite wounds. Design: Meta-analysis of published studies. Methods: A literature search was performed to iden tify published, randomized trials of prophylactic antibiotics for dog bite wounds. The relative risk for infection in treated patients compa red with controls was used as the measure of effect, and a summary rel ative risk was calculated. Results: Eight randomized trials were ident ified. The estimated cumulative incidence of infection in controls was 16%. The relative risk for infection in patients given antibiotics co mpared with controls was 0.56 (95% confidence interval, 0.38 to 0.82). About 14 patients must be treated to prevent one infection. Conclusio n: Prophylactic antibiotics reduce the incidence of infection in patie nts with dog bite wounds. The full costs and benefits of antibiotics i n this situation are not known. It may be reasonable to limit prophyla ctic antibiotics to patients with wounds that are at high risk for inf ection.