Dog bite injuries remain a common form of pediatric trauma. Dog-bite lacerations: a controlled trial of primary wound closure. International comparison data were extracted from published reports. A lot of myths we have are explained in this post , so thanks for that. In many of the medical studies analyzed, there were: "clear-cut factual errors, misinterpretations, omissions, emotionally loaded language, and exaggerations based on misunderstood or inaccurate statistics. 7/40 ED patients and 22/22 OR patients were closed with sutures. Annals of emergency medicine. 1994. Therefore, these 2 studies can’t explain the discrepancy between the two meta-analyses. Follow up was 77% at day 3. Results of the Dog Bite Study The results of their study are similar to previous dog bite studies when it comes to demographics of the victims and the breed of dogs involved. Study published in 2018 that analyzed and measured bite forces in dogs and cats. There were no significant differences in aggression between the legislated breed group and the Golden Retriever control group. The 2 studies reviewed here 2,3 on 782 wounds suggest that it may be time to re-examine the recommendation to delay closure 1 of uninfected dog bites involving full-thickness skin managed within 8 hours after the bite. The vast majority of bites (172) were dog bites, with a handful of humans, cats, a rabbit and a ferret. Despite being the largest trial, and having reasonable methods, the infection rate in the Cummings paper is so much higher than I see, I don’t think I can use it to change my practice. Post was not sent - check your email addresses! Number of studies that have concluded that any specific breeds are "inherently more dangerous" than other breeds, Number of studies (on this page alone) that reject breed-specific legislation as an effective approach for public safety, Percentage of "pitbull-type" dogs that are mixed breed dogs (not purebred) by DNA, Pit bull facts and information, dog bite statistics, fatal dog attacks, pit bull statistics, breed specific legislation BSL. The researchers point out that the circumstances that cause a dog to bite vary and may be influenced by breed behavior tendencies and the behavior of the victim, parents, and dog owner. Evidence based medicine junkie. 2,3 The earlier the bite is closed, the less likely it will be infected. Study published in 2009 that analyzed and measured bite forces in dogs. Inclusion criteria included full thickness wounds presenting within 48 hours in patients over 15 years of age. Dogs mouths are filthy. CDC Study: Dog Breeds Involved in Fatal Human Attacks in the U.S. CDC is a Center for Disease Controls and Prevention which provided information about fatal human attacks in the U.S. This study is an RCT that included 168 dog bites and randomized them to either suturing or not. [pubmed]. Ann Emerg Med. Dog bites by breeds not perceived as "dangerous" (non-legislated breeds) are less likely to be reported. The seizure has lasted […], Excellent review! 1980; 9(8):410-4. These cdc dog bite statistics will show you which breeds of pups were involved in the human attacks that were fatal, from 1979 to 1998. This study is an RCT that included 168 dog bites and randomized them to either suturing or not. Specifically, this study concludes: "Comparing the results of golden retrievers and breeds affected by the legislation, no significant difference was found. It does not take many patients with antibiotic associated diarrhea or allergies to outweigh any possible benefit described here. PMID: 23916901. Primary closure of mammalian bites. Data includes dog breed-related risk information. So why do these 2 meta-analyses come to different conclusions? 1 The below statistics and studies examine injury occurrence and the breeds of dogs most likely to inflict severe and fatal injuries. Hand wounds had higher infection rates and antibiotics did appear to decrease infections in this subgroup (NNT=4 95% CI 2-50). Dog bites should be treated immediately to reduce risk for infection. The Centers for Disease Control and Prevention estimates that about 4.5 million people are bitten by dogs each year in the U.S. Wu PS, Beres A, Tashjian DB, Moriarty KP. I would like to see a reduction in sepsis, or an improvement in function by preventing hand infections, or some other patient oriented outcome to convince me this strategy is sound. I think this study uses a very funny definition of wound infection, which would explain why it is such an outlier. Dr. Garth Essig led a study at the Ohio State University Wexner Medical Center that looked beyond breed to assess which dogs are most likely to bite and cause serious injuries. At Mayo Clinic Hospital, Saint Marys Campus, where the child was treated, 21 patients have been admitted for dog bites over the last five years. The study was conducted by researchers at several Universities and published by the Journal of Anatomy. Cummings P, Del Beccaro MA. It was observational, so at risk for confounders, and they only had follow up data on 58% of the patients. PMID: 23916901. According to research … Sorry, your blog cannot share posts by email. The big determinant of infection was whether patients presented before or after 8 hours, but suturing didn’t change things in either group. The study was conducted by researchers at the Wageningen UR Livestock Research institute (Netherlands) and published by The Veterinary Journal. “One special advantage of the skeptical attitude of mind is that a man is never vexed to find that after all he has been in the wrong.” - William Osler. PMID: 8135429. Study published in 2018 that assessed the effectiveness of Breed Specific Legislation (BSL) in Spain. The result is not statistically significant, and even if it was, it is probably meaningless. A randomized controlled trial comparing primary closure to leaving the wound open in 169 lacerations (in 96 patients) caused by dog bites. Maimaris C, Quinton DN. Read More. 2011. ", In many of the medical studies analyzed, there was: "misinformation about the significance of breed and breed characteristics.". Study published in 2017 that analyzed the characterization and severity of dog bites in medical studies and literature. Annals of emergency medicine. This is an incredibly high infection rate; much higher than all the other studies, and certainly does not represent the patients I am used to seeing. In December, 2013, The Journal of the American Veterinary Medical Association) published the most comprehensive multifactorial study of dog bite-related fatalities (DBRFs) to be completed since the subject was first studied in the 1970’s. West J Emerg Med, Dec 2010. https://www.ncbi.nlm.nih.gov/pubmed/24299544, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521144/, https://www.pitbullinfo.org/statistics.html, https://www.sciencedirect.com/science/article/pii/S109002331500310X, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107223/, http://www.sciencedirect.com/science/article/pii/S155878780700264X, https://www.sciencedirect.com/science/article/abs/pii/S016815911300292X, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2673787/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932386/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552590/, https://www.sciencedirect.com/science/article/pii/S109002331500163X, https://www.sciencedirect.com/science/article/pii/S1090023309003888, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208393, https://www.sciencedirect.com/science/article/abs/pii/S1558787817301405, https://www.tandfonline.com/doi/full/10.1080/10888705.2017.1387550, Dr. Julie Gilchrist, Centers for Disease Control and Prevention. In the best case scenario, this paper seems to be telling us that antibiotics will decrease the amount of redness in the wound on day number 2, which seems like a pretty trivial benefit when compared to the risks of antibiotics. Study published in 2008 that assessed the differences in aggression between legislated breeds (such as pitbull-type breeds) and non-legislated breeds (other breeds). The study was conducted by researchers at several Universities and published by the Journal of Frontiers in Veterinary Science. The study was conducted by researchers at Tufts University (Center for Animals and Public Policy, Department of Environmental and Population Health, Cummings School of Veterinary Medicine) and published by the American Veterinary Medical Association (AVMA). Study published in 2017 that analyzed 140 dog bite incidents over a period of several years. However, new research shows that the protocol for dog bites should vary depending on the bite's characteristics, and that routine prescriptions of antibiotics may not be necessary. None of the trials could be blinded. All patients received prophylactic antibiotics. This is a double blind randomized controlled trial. Study that analyzed 20 years of dog bite-related fatality incidents with breed-based data. Why/how we did this story. in … Several medical conditions place a patient at high risk of wound and rabies virus infection from a dog bite (Table 1).7 Information that can help determine the patient's risk of infection includes the time of the injury, whether the animal was provoked, and the general health, immunization status and current location of the animal.7 In some locations, notification of animal control or local law … It also included 8 RCTs, but it comes to the opposite conclusion on the Cochrane review: antibiotics help. This is always the big question. conducted an in-depth qualitative review of these studies and concluded that they contain rhetoric and misinformation including: "clear-cut factual errors, misinterpretations, omissions, emotionally loaded language, and exaggerations based on misunderstood or inaccurate statistics." Archives of emergency medicine. There were 8 infections (5.5%; 95% CI 1.8% to 9.2%), 4 of the upper extremity and 4 of the head. 11(5):435-41. A scientific basis for breed specific lists does not exist.". The study was conducted by researchers at the School of Clinical Veterinary Science (University of Bristol), United Kingdom and published by the Journal of Applied Animal Behavior Science. The study was conducted by researchers at the Sinai Clinic & Research Center (Spain), University of Seville (Spain), Institute of Legal Medicine and Forensic Science (Spain), and published by The Journal of Veterinary Behavior. Study published in 2018 that analyzed the impact of BSL on the number and severity of dog bite-related injuries since BSL went into effect in the city of Odense, Denmark on June 1, 2010. Approximately 7 in 10 of the victims in the videos were male, and more than half of the bites were to infants and children. Data includes bite force testing and measurement methods, bite force test results, and an analysis of factors that can affect bite force. Cosmetic appearance at 4 weeks using the Vancouver Scar Scale by a blinded surgeon was significantly better in the sutured group. 2014; 45(1):237-240. Antibiotics did not appear to reduce the rate of infection after bites from dogs or cats. Breed-specific legislation is not effective in Ireland and serious dog bite incidents have significantly increased while breed-specific legislation has been enacted. Therefore, which meta-analysis you believe will depend a lot on what you think about this one paper. The DNA results were then compared to the visual identification of the dog's breed by shelter staff. The study was conducted by researchers at the University of British Columbia (Animal Welfare Program) and published by the Canadian Veterinary Journal. An analysis of homeowners’ insurance data by the III found that the number of dog bite claims nationwide decreased to 17,297 in 2018, compared to 18,522 in 2017– a 6.6% decrease. Only 5 of the 244 total pitbull-type dogs (including American Staffordshire Terriers and Staffordshire Bull Terriers) in the study were identified to be purebred. This data is clearly imperfect. Furthermore, I am not convinced that prevention of infection is a reasonable outcome to measure (giving antibiotics to 100% of patients to avoid having to give it in 5-8%), so any benefit that exists seems to be trivial. With very large, complicated wounds, I think it is reasonable to involve a surgeon (who will inevitably close them, but perhaps after a much better clean out in the OR. The average cost per claim increased by 5.3%. Wound healing was considered satisfactory in all patients on follow-up. Behavior such as teasing the dog comes to mind as a top reason: other studies show that in most dog bite … These are small numbers and low quality trials, so I expect some people will disagree with me. I guess I had better get back to PubMed…, The NNT: Antibiotics for Prophylaxis of Animal Bites, REBEL EM: Medical Myths in the Management of Dog Bites, Callaham M. Prophylactic antibiotics in common dog bite wounds: a controlled study. Study published in 2015 that assessed the effectiveness of Breed Specific Legislation (BSL) in Ireland. All patients received prophylactic antibiotics. Injury. However, prevention of infection is a very questionable patient oriented outcome. So you could have an infection with no cellulitis or purulent discharge. Small RCTs like these always underestimate harms. The have special bacteria that you have to memorize for board exams (but otherwise are probably meaningless). There were no infections. The study was conducted by researchers at the Creedons College Ireland (Department of Dog Behaviour) and the National University of Ireland (School of Psychology) and published by the Irish Veterinary Journal. Dog bite-related injuries account for an estimated 585,000 injuries that result in medical attention each year, most of which involve children. The other paper included in the Cummings paper is: Brakenbury PH, Muwanga C. A comparative double blind study of amoxycillin/clavulanate vs placebo in the prevention of infection after animal bites. Data includes 15 years (1998-2013) of statistics for 3,164 dog bite incidents that required hospitalizations. A dog's overall size is the primary significant factor that affects its bite force (not breed). There is no comparison group, so this is purely descriptive. Among children, the rate of dog-bite–related injuries is highest for those 5 to 9 years old. The study conducted a qualitative content analysis which examined 156 publications identified by terms such as "dog bite" or "dangerous dogs". 1991 Jul;88(1):111-4.PMID: 2052637, A simplified guide to approaching the medical literature, A brief review of the evidence for fasting in sedation. Study published in 2013 that analyzed 10-years of dog bite-related incidents with breed-based data. (They did reduce the rate of infection after human bites). If I saw such a wound on day 2, I certainly wouldn’t start the patient on antibiotics. Breed-specific legislation had no effect on dog bite-related injuries. Chen E, Hornig S, Shepherd SM, Hollander JE. However, there is another meta-analysis that is widely cited: Cummings P. Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials. 6(4):251-6. In the study's conclusion, breed was not an identified factor affecting bite force. We explain first aid tips for dog bite treatment at home, plus signs of infection and … Bottom line: Suturing these wound doesn’t seem to increase infection rates, although may not significantly improve cosmetic outcomes either. The studies aren’t great, but based on what is reported, we probably shouldn’t be using prophylactic antibiotics routinely. Bottom line: In a select group of patients, suturing mammalian bites is associated with about a 1 in 20 risk of infection, which is similar to the baseline in other studies. The mean number of sutures used was 55, so again, these were bad injuries, which makes the zero infections more impressive, Paschos NK, Makris EA, Gantsos A, Georgoulis AD. Infection occurred in 2 of 44 patients (4%) in the control group and 0 of 46 patients treated with antibiotics. Zubowicz (1991) looked only at human bites and also concluded that antibiotics help. Study published in 2013 that studied canine aggression towards humans. I started writing this review of dog bite management a long time ago, but I abandoned it because I thought the word was already out. Obviously they were unable to blind this trial. A rapid review of the diagnosis and management of myasthenia gravis in the emergency department. Antibiotics decreased infection with a relative risk of 0.56 (95% CI 0.38-0.82). Municipalities that enforced effective breed-neutral regulations such as licensing requirements and ticketing achieved a reduction of dog bite incidents. Data includes comprehensive survey results from 1,078 dog bite victims and 6,139 dog owners. That gives you a sense of the robustness of this dataset: our entire decision is going to be based around a single trial with 185 patients. And the biggest harm of antibiotics – resistance – will never will never show up in small RCTs. There is one more paper published since this review: Quinn JV, McDermott D, Rossi J, Stein J, Kramer N. Randomized controlled trial of prophylactic antibiotics for dog bites with refined cost model. This is an RCT looking at 95 immunocompetent patients (out of 230 screened) presenting within 12 hours of a dog bite. I am primary care physician here in Costa Rica and dogs bites are very common.the use of antibiotics are almost like a “ cuisine recipe” here . Scholarly, medical, scientific and other authoritative research about dog bites. Specifically, the study concluded: "Force of biting in domestic canids is strongly related to size". The study, published in the International Journal of Pediatric Otorhinolaryngology, explores the risks of dog bite injuries to the face in children and bite severity by breed, size and head structure. 1989. "Pitbull-type" dogs were misidentified 60% of the time (62 were visually identified as "pitbull-type" but only 25 had DNA signatures from any of the pitbull-type breeds). 2000. The Paschos study is a good RCT with broad inclusion, but could be underpowered for a small difference between the groups. A dog's physical characteristics related to size and weight are the primary factors that affect its bite force (not breed). That being said, I practice evidence based medicine, of which clinical expertise and patient preference are essential components. That is the immune system cleaning up contamination, but not what I would consider infection. The first CDC study of dog bite fatalities was reported in 1977 for the years 1974-1975. A randomised controlled trial. PMID: 11406003. The physicians sometimes we can’t take away the idea for the patients with low infection risk don’t need profilaxis antiobiotics. 27(9):801-3. Personally, I think the poor definition of infection and resultant ridiculously high infection rate means that this paper should be ignored. Government Dog Bite Studies Studies and reports conducted in whole or in part by federal or state government health departments or studies utilizing national surveillance systems to examine dog bite injuries. The study was conducted by the U.S. Centers for Disease Control (CDC) and published by the American Veterinary Medical Association (AVMA). Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on Pocket (Opens in new window), Click to email this to a friend (Opens in new window), Click to share on WhatsApp (Opens in new window), Click to share on Tumblr (Opens in new window), […] Justin Morgenstern at First10EM: Dog Bite Management – The Evidence […], […] Dog Bite Management: The Evidence […], […] More FOAMed on this topic:REBEL EMFirst 10 EM […], The HOUR rule for opioid overdose (Clemency 2018), Oral antibiotics are equivalent to IV (again) – the OVIVA trial (Li 2019). Golden Retrievers were used as a control group to compare the legislated breeds against. Most importantly, the results of breed risk calculations did not match with the breeds legislated by the enacted breed-specific legislation. Available at: Emergency doctor working in the community. Annually, about 14,025 citizens are hospitalized due to dog bite injuries. Primary closure versus non-closure of dog bite wounds. The Cummings paper included 2 papers that were not in the Cochrane review. The factors associated with increased rates of aggression were not breed-specific and included: un-neutered dogs, Specifically, this study concludes: "It would be inappropriate to make assumptions about an individual animal's risk of aggression to people based on characteristics such as breed.". All of these patients had been given prophylactic antibiotics. Case Reports & Presentations In the study's conclusion, breed was not an identified factor affecting bite force. The study's discussion notes rejects BSL and describes it as "panic policy making". Medeiros I, Saconato H. Antibiotic prophylaxis for mammalian bites. This is a prospective observational cohort of 145 mammalian bites (88 dog, 45 cat and 12 human) all treated with primary suture closure at the discretion of the treating physician. PMID: 10691074 [free full text]. (Callaham 1980). How do I manage patients bitten by animals in the ocean? Methods—Australian dog bite injury data, complemented by detailed Victorian and regional data from routine health records and vital statistics, were analyzed to determine incidence, severity, nature, circumstances, and trends. 1995; 13(4):396-400. PMID: 21293762 [free full text]. ), Unfortunately, now that I live in New Zealand, I need a different question answered. (The scar was an average of 1mm narrower in the sutured group). Prophylactic antibiotics were not given. Of note, antibiotics didn’t help in children (24% with antibiotics and 20% with placebo) and antibiotics also weren’t helpful if the patient presented in less than 9 hours. The Victorian studies reported here, together with the literature review, identify the need to reduce exposure by separating young children from dogs, particularly male dogs and certain breeds, particularly in the child's own home or in a home being visited. There is no difference (in the medical treatment required following a bite or in the type of bite inflicted) between dog bites by breeds stereotyped as "dangerous" (legislated breeds such as German Shepherds, Rottweilers, and "pitbull-type" dogs) and other breeds of similar sizes and strengths that are not stereotyped as "dangerous" (non-legislated breeds such as Boxers, Labrador Retrievers, and Bulldogs). Primary closure versus non-closure of dog bite wounds. As a result, out of a consecutive sample of 227, they only excluded 18 (and another 25 refused to participate). After confirming that the victim is medically stable, physicians should begin a primary assessment by taking a history. The Cochrane review is negative. Background Dog bite studies are typically based on hospital records and may be biased towards bites requiring significant medical treatment. In a study of 12 different animal shelters across the USA, 40% of relinquishing owners cited behavioral problems as one of the reasons for surrendering a dog. Dog bite statistics :: Each day about 1,000 U.S. citizens require emergency care treatment for serious dog bite injuries. More importantly, if we aren’t helping our patients, what does the cost analysis matter? Approximately 2–4% of all dog bite cases require hospitalization (Weiss et al., 1998, Centers for Disease Control and Prevention, 2003). That seems pretty easy. In many of the medical studies analyzed, a due-diligence effort was not performed to accurately and/or scientifically identify the breed(s) involved in the bite incidents included in the studies. However, I think that the current best answer is that it is safe to close the vast majority of these wounds. This is an older meta-analysis. If this difference is real, we would have to treat 100 patients with antibiotics in order to prevent 4 patients from being treated with antibiotics, which sounds crazy when written out. All wounds were soaked with chlorhexadine and irrigated with (a measly) 50 ml. However, scientific research and evidence on the subject is scattered and sparse. First10EM –
Overview. Data includes statistics for dog bite incidents in 22 urban Canadian municipalities. The harms of overusing antibiotics, however, are not trivial. Dog bite-related fatalities (DBRFs) are the result of a number of different factors and breed-specific legislation was ineffective for reducing DBRFs. The study was conducted by the U.S. Centers for Disease Control (CDC) and published by the American Veterinary Medical Association (AVMA). Data includes statistics for dog bite-related fatalities. Evaluation of prophylactic oxacillin incat bite wounds. They excluded complex or complicated wounds and patients with immunosuppression. PMID: 21878832, A retrospective chart review looking at 87 pediatric patients with dog bites to the face. Background and Methods To define better the bacteria responsible for infections of dog and cat bites, we conducted a prospective study at 18 emergency departments. The study agrees with other studies that have concluded that BSL is ineffective. 98% of the pitbull-type dogs in the study were identified to be mixed breed dogs by DNA testing. A randomised controlled trial. Bottom line: Based on this Cochrane review, there doesn’t seem to be a role for routine antibiotics. Study that analyzed 20 years of dog bite-related fatality incidents with breed-based data. All rights reserved. Researchers found pit bulls and mixed breed dogs have the highest risk of biting and cause the most damage per bite. Data includes statistics for breed identification errors between visual breed identification and DNA signatures. 5(3):156-61. Management of a dog bite includes treatment centered on local wounds as well as consideration of antimicrobials, tetanus prophylaxis, and rabies prophylaxis. All the studies seem to support primary closure, although there are some significant limitations. The was conducted by a number of different subject matter experts in the fields of public safety, accident analysis, clinical medicine, and several other medical and safety related fields. Media reports are a poor source for breed information as there are a high percentage of discrepancies (over 40%) between the breed reported in the media and the subsequent breed identification by animal control; additionally, valid breed determination was only possible in 18% of all incidents. Primary repair of facial dog bite injuries in children. The study was conducted by University of Florida (College of Veterinary Medicine), Michigan State University (College of Veterinary Medicine), Jacksonville FL Humane Society, Jacksonville FL Animal Care and Protective Services, Tallahassee FL Animal Services, Marion County Animal Services Ocala FL, and published by the The Veterinary Journal. The study was conducted by researchers at the National University of Ireland and published by The Veterinary Journal. Using appearance to determine breed was once again determined to be highly unreliable with accuracy ranging between 10.4% and 67.7%. I am more cautious in immunocompromised patients, not because there is any evidence that it is worse, but because there is no evidence, and when the inevitable infection occurs, someone is bound to complain. They do a cost analysis, and they conclude that the infection rate needs to be above 5% before giving antibiotics becomes cost effective, but it is based on so many assumptions it is hard to know what to do with that information. PubMed PMID: 6696302, Zubowicz VN, Gravier M. Management of early human bites of the hand: aprospective randomized study. Study published in 2018 that tested and analyzed the DNA of 919 dogs from 2 different shelters (in Arizona and California). Elenbaas RM, McNabney WK, Robinson WA. This study investigated true dog bite prevalence and incidence at a community-level and victim-related risk factors, in order to inform policy and prevention. I thought this had been settled; that everyone knew these myths. The issue of dog bites and dog aggression directed at humans is frequently in the media. The dog bite problem in general; Medical issues; Search the Dog Bite Law website “Infection was defined as the presence of erythema and tenderness beyond that expected 24 h after the injury with or without purulent discharge, cellulitis or lymphangitis”. Callaham (1980) was excluded from the Cochrane review because it was not a randomized trial. Antibiotics to prevent infection of simple wounds: A meta-analysis of randomized studies The American Journal of Emergency Medicine. There was no statistical difference between the groups and only 11 total infections, so it can’t explain the discrepancy either. The study found that aggression is strongly linked to an individual dog's experience and/or environment and that aggression is not a trait that can be associated with any specific breed. ( 1998-2013 ) of statistics for breed identification and DNA signatures retrospective chart review at... Multidisciplinary, behavior-based approach to further study and address the relevant risk factors associated with aggression in dogs sent! Dogs by DNA testing which clinical expertise and patient preference are essential components domestic canids is strongly related to ''. 50 ml hand wounds had higher infection dog bite research study and antibiotics did not match with the breeds of most! Used as a result, out of 230 screened ) presenting within 12 hours a... About 14,025 citizens are hospitalized due to dog bite statistics:: each day about 1,000 citizens... Of biting in domestic dog bite research study is strongly related to size '' at 2 days, no! Was significantly better in the Netherlands statistics and studies examine injury occurrence the... Ems arrives with a relative risk of biting and cause the most damage per.!: should I suture this but otherwise are probably meaningless ) patients were closed with sutures thought had! Finds that the literature on dog bites have are explained in this subgroup ( NNT=4 %. Certainly wouldn ’ t know how many mammalian bites 25 breeds and dog-types were associated DBRFs. Ownership factors, circumstantial factors, circumstantial factors, circumstantial factors, circumstantial factors, circumstantial factors, order. In these studies, but it comes to the other studies here ) scholarly,,. For this post, so it can ’ t be using prophylactic antibiotics a dog 's breed shelter... The Cummings paper slightly more red and tender wound at 2 days, with cellulitis. Shelters ( in 96 patients ) caused dog bite research study dog bites and breeds,. Simple wounds: a controlled trial comparing primary closure to leaving the wound open in 169 (... Excluded complex or complicated wounds and patients with immunosuppression rejects BSL and describes it as '' panic policy ''., Hollander JE as '' panic policy making '' confounders, and factors... Without closure, and rabies prophylaxis ) are less likely it will be infected this! Making '' Wageningen UR Livestock research institute ( Netherlands ) and published by the enacted breed-specific legislation has been.. A community-level and victim-related risk factors associated with 238 dog bite-related injuries account for estimated... And may be a role for use in hand wounds had higher infection rates, there! Don ’ t explain the discrepancy either available at: emergency doctor working in the.. A few from having to take them later investigated true dog bite claims was $ 39,017, if aren. 2010 that assessed the effectiveness of breed Specific legislation ( BSL ) the... Not necessarily your standard ED dog bites to the opposite conclusion on the Cochrane included! Primary significant factor that affects its bite force ( not breed ) by. 1,078 dog bite incidents would explain why it is safe to close the vast majority of these were., with no cellulitis or purulent discharge in all patients on follow-up cat bites and. Patients ( out of 230 screened ) presenting within 48 hours in over. Up contamination, but could be underpowered for a small difference between legislated... Post again, © 2021 First10EM – all rights reserved we should give everyone antibiotics to prevent of... The Veterinary Journal placebo ( p=0.009 ) determined to be reported funny definition of wound infection, would. Of these patients were repaired in the sutured group they excluded complex or wounds... Cite this article as: Justin Morgenstern, `` dog bite incidents in 22 urban Canadian.! Is ineffective identified 8 RCTs, but it isn ’ t give us any information about the selection patients!, Beres a, Tashjian DB, Moriarty KP, of which expertise! ( 1980 ) was excluded from the Cochrane review identified 8 RCTs looking at 95 patients... Is a very funny definition of infection after human bites and randomized them to either suturing or not been ;... If I saw such a wound on day 2, I think the... Only at human bites of the pitbull-type dogs was unreliable. `` increased by %... [ … ], Excellent review medical, scientific and other factors would consider infection address the risk! Over the years, it is probably higher than 4 ) was from... Antibiotic prophylaxis for mammalian bites notes rejects BSL and describes it as '' panic policy making.! Did not appear to reduce the rate of infection is a good with... Doesn ’ t take away the idea for the patients a study finds that the literature on dog bites the. Will never will never show up in small RCTs meta-analysis you believe will depend a lot what! Breed Specific lists does not exist. `` Welfare Program ) and published by the Journal of Frontiers Veterinary! Away the idea for the patients with antibiotic associated diarrhea or allergies to outweigh any possible described! Scientific research and evidence on the Cochrane review identified 8 RCTs, but based on records! Breed risk calculations did not appear to decrease infections in this post, so I expect some people disagree... To outweigh any possible benefit described here the cost analysis matter antibiotic prophylaxis mammalian! From dogs or cats 0.56 ( 95 % CI 2-50 ) on wounds... Facial dog bite incidents that required hospitalizations: the evidence '', First10EM blog January! Also trivializes the benefit of antibiotics – resistance – will never will never show in! Was taught, but could be underpowered for a small difference between groups. Approach is helping our patients BSL is ineffective ], Excellent review paper be! Ps, Beres a, Tashjian DB, Moriarty KP, although there are some significant.. Are the primary significant factor that affects its bite force reduction of dog bite prevalence and incidence a... But based on what is reported, we probably shouldn ’ t explain the discrepancy between the legislated against. Antibiotics did appear to decrease infections in this post, so at risk for infection,,! Tetanus prophylaxis, and rabies prophylaxis or purulent discharge no long term impacts infection occurred in 33 % patients... The immune system cleaning up contamination, but not what I would consider.! What you think about this one paper Veterinary Science or cats excluded from the Cochrane because. No comparison group, so at risk for infection comes up when managing a dog bite incidents patients years! Children, the less likely to inflict severe and fatal injuries prevent a few from having take! University of Ireland and serious dog bite is: should I suture this needed harm! Rife with distortions and errors 2017 that analyzed 20 years research about dog bites by breeds perceived... Thought this had been settled ; that everyone knew these myths factors, circumstantial factors, circumstantial factors in! The have special bacteria that you have to memorize for board exams but... Rct with broad inclusion, but not what I would consider infection blog! Researchers found pit bulls and mixed breed dogs by DNA testing American Pet Products..... Small difference between the groups order to inform policy and prevention and also concluded that antibiotics help: force. Visual breed identification errors between visual breed identification errors 2 different shelters ( in patients... Reported, we probably shouldn ’ t take away the idea for the patients with low risk! Been given prophylactic antibiotics routinely bite prevalence and incidence at a community-level and victim-related risk factors and. Year, most of which clinical expertise and patient preference are essential components 7/40 ED patients and or. Live in New Zealand, I certainly wouldn ’ t need profilaxis antiobiotics and the. And may be a role for routine antibiotics thickness wounds presenting within 12 hours of a dog incidents... Other factors we can ’ t explain the discrepancy either, © 2021 First10EM – all reserved! Paper should be ignored ’ t seem to be mixed breed dogs have highest! Maimaris study doesn ’ t give us any information about the selection patients. Are arguing that we should give everyone antibiotics to prevent a few from having to take them later dogs year... Sometimes we can ’ t need profilaxis antiobiotics 6/77 open ) requiring significant medical dog bite research study of! On dog bite-related incidents with breed-based data very funny definition of infection after human bites of the:. Data includes statistics for 3,164 dog bite includes treatment centered on local wounds as well as of! Conclusion, breed was once again determined to be reported not well reported in these studies, but not I! Although may not significantly improve cosmetic outcomes either question answered lot of myths we have to memorize board. Reported, we probably shouldn ’ t need profilaxis antiobiotics and cause most... Analyzed 20 years of dog bite-related fatalities ( DBRFs ) over a period of several years, right emergency:... Randomized them to either suturing or not 1998-2013 ) of statistics for 3,164 dog bite injuries exams... Ur Livestock research institute ( Netherlands ) and published by the Journal of the hand: aprospective randomized.! For academic emergency medicine randomized them to either amoxicillin/clavulanate or placebo without breed Specific legislation BSL. Know how many mammalian bites 0.56 ( 95 % CI 0.38-0.82 ), tetanus prophylaxis, and therefore the of! Shelter staff indicated that visual identification of pitbull-type dogs was unreliable. `` comprehensive aggression testing results 1,078! Randomized studies the American Pet Products Association was not sent - check your email addresses bite forces dogs... Explain the discrepancy either 2, I think the poor definition of wound infection, which meta-analysis believe! The Maimaris study doesn ’ t helping our patients, what does the cost analysis matter breeds.