Use of antibiotics in patients who were attacked by animals that can transmit rabies

Zoonoses Public Health. 2022 Dec;69(8):978-986. doi: 10.1111/zph.12995. Epub 2022 Aug 28.


Animal bites have a high probability of becoming infected. In high-risk wounds, the use of antibiotics that kill the associated microorganisms is recommended. The aim of this study was to determine the use of inappropriate antibiotics in patients in different regions of Colombia who were attacked in 2020 by animals that can transmit rabies. This was a retrospective follow-up study of a cohort of patients with wounds caused by animals; the patients were affiliated with the Colombian Health System. Sociodemographic, clinical and pharmacological data were collected. A total of 280 patients were analysed. The median age was 28.0 years, and 52.1% were men. The attacks were attributed to dogs (85.0%) and cats (15.0%), and 9.6% were classified as severe exposure. Antibiotics were used in 71.1% of cases for prophylaxis and in 4.3% of the cases for the treatment of superinfection; cephalexin (37.5%), amoxicillin/clavulanic acid (15.7%) and dicloxacillin (10.4%) were the predominant antibiotics used. A total of 72.0% of patients who received antibiotics received inadequate prescriptions, and 49.2% had no indication to receive prophylaxis. Being treated in the Caribbean region (OR: 4.09; 95% CI: 1.79-9.30) and receiving analgesics (OR: 3.15; 95% CI: 1.25-7.94) were associated with a greater probability of being prescribed antibiotics inadequately; attacks resulting in severe exposure were associated with a lower probability (OR: 0.40; 95% CI: 0.16-0.98). A significant proportion of patients had no indication for prophylactic antibiotics or was prescribed antibiotics not recommended by clinical practice guidelines. There was a low prevalence of prescriptions for amoxicillin/clavulanic acid, the most recommended antibiotic.

Keywords: amoxicillin-clavulanic acid; anti-bacterial agents; antibiotic prophylaxis; bites and stings; cephalexin; inappropriate prescribing.

MeSH terms

  • Amoxicillin-Potassium Clavulanate Combination
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Dog Diseases* / drug therapy
  • Dogs
  • Follow-Up Studies
  • Rabies* / drug therapy
  • Rabies* / epidemiology
  • Rabies* / veterinary
  • Retrospective Studies


  • Anti-Bacterial Agents
  • Amoxicillin-Potassium Clavulanate Combination