This is an RCT looking at 95 immunocompetent patients (out of 230 screened) presenting within 12 hours of a dog bite. 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. None of the trials could be blinded. 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. Background Dog bite studies are typically based on hospital records and may be biased towards bites requiring significant medical treatment. The average cost per claim increased by 5.3%. Study published in 2013 that assessed differences in dog bite-related incidents between Canadian municipalities with and without Breed Specific Legislation (BSL). "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). After confirming that the victim is medically stable, physicians should begin a primary assessment by taking a history. PMID: 3178974 [free full text]. The average cost paid out for dog bite claims was $39,017. Dog bite injuries remain a common form of pediatric trauma. Annals of emergency medicine. It also included 8 RCTs, but it comes to the opposite conclusion on the Cochrane review: antibiotics help. Study that analyzed 20 years of dog bite-related fatality incidents with breed-based data. The study was conducted by the U.S. Centers for Disease Control (CDC) and published by the American Veterinary Medical Association (AVMA). Antibiotics to prevent infection of simple wounds: A meta-analysis of randomized studies The American Journal of Emergency Medicine. Annually, about 14,025 citizens are hospitalized due to dog bite injuries. 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. Antibiotics decreased infection with a relative risk of 0.56 (95% CI 0.38-0.82). All of these patients had been given prophylactic antibiotics. A scientific basis for breed specific lists does not exist.". “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”. Primary closure versus non-closure of dog bite wounds. 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. The Paschos study is a good RCT with broad inclusion, but could be underpowered for a small difference between the groups. 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. Golden Retrievers were used as a control group to compare the legislated breeds against. 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. However, more than ½ of these patients were repaired in the OR, so these are not necessarily your standard ED dog bites. The physicians sometimes we can’t take away the idea for the patients with low infection risk don’t need profilaxis antiobiotics. PMID: 23916901. (They did reduce the rate of infection after human bites). As a result, out of a consecutive sample of 227, they only excluded 18 (and another 25 refused to participate). West J Emerg Med, Dec 2010. Study published in 2018 that tested and analyzed the DNA of 919 dogs from 2 different shelters (in Arizona and California). PMID: 8135429. Inclusion criteria included full thickness wounds presenting within 48 hours in patients over 15 years of age. Archives of emergency medicine. 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. Callaham (1980) was excluded from the Cochrane review because it was not a randomized trial. Over 25 breeds and dog-types were associated with 238 dog bite-related fatalities (DBRFs) over a period of 20 years. There was no statistical difference between the groups and only 11 total infections, so it can’t explain the discrepancy either. So why do these 2 meta-analyses come to different conclusions? More importantly, if we aren’t helping our patients, what does the cost analysis matter? Evaluation of prophylactic oxacillin incat bite wounds. "Lack of consistency among shelter staff indicated that visual identification of pitbull-type dogs was unreliable.". Elenbass (1984) looked only at cat bites, and concluded that antibiotics were helpful. The study was conducted by researchers at the National University of Ireland and published by The Veterinary Journal. 2014; 45(1):237-240. Small RCTs like these always underestimate harms. 1989. This study is an RCT that included 168 dog bites and randomized them to either suturing or not. Infection in the control group was 16% (somewhat high as compared to the other studies here). 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. Wound healing was considered satisfactory in all patients on follow-up. For now, I follow the Cochrane review and do not routinely provide prophylactic antibiotics, but this area is ripe for one large, high quality RCT. Dog bite statistics :: Each day about 1,000 U.S. citizens require emergency care treatment for serious dog bite injuries. Injury. 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. Post was not sent - check your email addresses! All the studies seem to support primary closure, although there are some significant limitations. However, scientific research and evidence on the subject is scattered and sparse. 1980; 9(8):410-4. The other big question that comes up when managing a dog bite is: should I suture this? “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. 5(3):156-61. 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. These are small numbers and low quality trials, so I expect some people will disagree with me. However, prevention of infection is a very questionable patient oriented outcome. 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. Plast Reconstr Surg. tional study—of 769 sequential p atients with dog bite wou nd s pr ese nt ing to a n em erg en cy d epa rt men t— found t hat the strong est pre dictor s for th e devel op- Archives of emergency medicine. Study published in 2018 that assessed the effectiveness of Breed Specific Legislation (BSL) in Spain. International comparison data were extracted from published reports. in … Data includes statistics for dog bite-related fatalities. Data includes a comprehensive analysis of multiple risk factors associated with aggression in dogs. 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). A randomised controlled trial. ), Unfortunately, now that I live in New Zealand, I need a different question answered. 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. Researchers found pit bulls and mixed breed dogs have the highest risk of biting and cause the most damage per bite. Data includes dog breed-related risk information. The study recommends a multidisciplinary, behavior-based approach to further study and address the relevant risk factors associated with DBRFs. Data includes dog bite-related risk information. Behavior such as teasing the dog comes to mind as a top reason: other studies show that in most dog bite … The study was conducted by researchers at the Wageningen UR Livestock Research institute (Netherlands) and published by The Veterinary Journal. This is an older meta-analysis. 1984 Mar;13(3):155-7. 1 The below statistics and studies examine injury occurrence and the breeds of dogs most likely to inflict severe and fatal injuries. The study was conducted by researchers at Northeastern University (Boston, MA), Tufts University - Cummings School of Veterinary Medicine (North Grafton, MA), and other subject matter experts. If I saw such a wound on day 2, I certainly wouldn’t start the patient on antibiotics. Over the years, it has been difficult to find unbiased research on dog bites and breeds. 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. Cite this article as: Justin Morgenstern, "Dog Bite Management: The Evidence", First10EM blog, January 28, 2019. Medeiros I, Saconato H. Antibiotic prophylaxis for mammalian bites. 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. The findings of this study are consistent with and extend from previous publications [5,7,11–13,16,21,22,29]. 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 . However, a few recent conversations have highlighted the fact that the management of dog bites is still steeped in controversy with wide practice variations. All patients received prophylactic antibiotics. 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. This very loose definition explains the crazy 60% infection rate, but also trivializes the benefit of antibiotics. Maimaris C, Quinton DN. Why/how we did this story. 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. We don’t know how many mammalian bites were treated without closure, and therefore the degree of selection bias. Read More. This is always the big question. The DNA results were then compared to the visual identification of the dog's breed by shelter staff. Most importantly, the results of breed risk calculations did not match with the breeds legislated by the enacted breed-specific legislation. There were no significant differences in aggression between the legislated breed group and the Golden Retriever control group. (The scar was an average of 1mm narrower in the sutured group). AKRON, Ohio — A new study is giving insight into which dog breeds are most at risk to bite people and how severe the injuries could be. Data includes statistics for breed identification errors between visual breed identification and DNA signatures. Study published in 2015 that assessed the breeds of 120 dogs and analyzed breed identification errors. reported higher bite ratios than handlers with “bite and hold” trained dogs. 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. The study conducted a qualitative content analysis which examined 156 publications identified by terms such as "dog bite" or "dangerous dogs". PMID: 10691074 [free full text]. 2001. 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. With all that bacteria, we have to give antibiotics, right? In other words, these studies are scientifically unsound sources for breed-risk information (as they contain errors and invalid methods) and some were even found to include cherry-picked data to support unscientific conclusions. 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. Prophylactic antibiotics were not given. Breed-specific legislation is not effective in Ireland and serious dog bite incidents have significantly increased while breed-specific legislation has been enacted. 2,3 The earlier the bite is closed, the less likely it will be infected. 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. There were no infections. 6(4):251-6. 7(2):157-61. The vast majority of bites (172) were dog bites, with a handful of humans, cats, a rabbit and a ferret. Therefore, which meta-analysis you believe will depend a lot on what you think about this one paper. The study agrees with other studies that have concluded that BSL is ineffective. Study published in 2010 that assessed the effectiveness of Breed Specific Legislation (BSL) in the Netherlands. American households include almost 90 million dogs, according to the American Pet Products Association.. Dog bites should be treated immediately to reduce risk for infection. 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. Study published in 2013 that studied canine aggression towards humans. I talk to all my patients and in those at a very high risk of infection (especially prolonged or complicated infection) I will offer antibiotics. A study finds that the literature on dog bites written by human health care professionals is rife with distortions and errors. 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. Bottom line: Based on this Cochrane review, there doesn’t seem to be a role for routine antibiotics. Ann Emerg Med. 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. Chen E, Hornig S, Shepherd SM, Hollander JE. 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. 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. That is certainly how I was taught, but it isn’t clear that that approach is helping our patients. According to research … 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. 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. Data includes statistics for dog bite incidents in 22 urban Canadian municipalities. We explain first aid tips for dog bite treatment at home, plus signs of infection and … First10EM – [pubmed]. Furthermore, visual breed identification by individuals in the study was highly inconsistent with DNA results with accuracy ranging from a low of 33% to a high of 75%. Case EMS arrives with a 39 year old woman in the midst of a generalized tonic clonic seizure. Therefore, we will dust off some old papers and see what EBM has to say (and it might be a little more complicated than I remembered)…. It does not take many patients with antibiotic associated diarrhea or allergies to outweigh any possible benefit described here. Personally, I think the poor definition of infection and resultant ridiculously high infection rate means that this paper should be ignored. Breed-specific legislation had no effect on dog bite-related injuries. 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." Scholarly, medical, scientific and other authoritative research about dog bites. 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. This data is clearly imperfect. 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. Dogs labeled as a pitbull-type breed had an average DNA concentration of 43.5% from pitbull-type ancestry (38.5% average in shelter 1 and 48.4% average in shelter 2) and the majority (62% or 152 of 244) of pitbull-type dogs in the study had less than a 50% DNA concentration from pitbull-type ancestry. PMID: 21293762 [free full text]. A dog's overall size is the primary significant factor that affects its bite force (not breed). The harms of overusing antibiotics, however, are not trivial. The Cochrane review included 2 studies not in the Cummings paper. I am not sure that makes any sense. 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. Previous Next. 1994. A rapid review of the diagnosis and management of myasthenia gravis in the emergency department. Data includes statistics for dog bite-related fatalities. Primary closure of mammalian bites. A dog's physical characteristics related to size and weight are the primary factors that affect its bite force (not breed). 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. They excluded complex or complicated wounds and patients with immunosuppression. Approximately 7 in 10 of the victims in the videos were male, and more than half of the bites were to infants and children. A randomised controlled trial. In the study's conclusion, breed was not an identified factor affecting bite force. Using appearance to determine breed was once again determined to be highly unreliable with accuracy ranging between 10.4% and 67.7%. 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. Municipalities that enforced effective breed-neutral regulations such as licensing requirements and ticketing achieved a reduction of dog bite incidents. In the study's conclusion, breed was not an identified factor affecting bite force. Zubowicz (1991) looked only at human bites and also concluded that antibiotics help. 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. 2011. The big determinant of infection was whether patients presented before or after 8 hours, but suturing didn’t change things in either group. The objective of this study was to characterise the behavioural circumstances of dog bites by interviewing children ≤17 years (or parent proxies for children ≤6 years) presenting with dog bite injuries to the Children’s Hospital of Philadelphia about the … 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. How do I manage patients bitten by animals in the ocean? 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 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. PMID: 2692580 [free full text]. 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. 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. Case Reports & Presentations All rights reserved. There is no comparison group, so this is purely descriptive. Specifically, the study concluded: "Force of biting in domestic canids is strongly related to size". Dogs mouths are filthy. This is a double blind randomized controlled trial. 98% of the pitbull-type dogs in the study were identified to be mixed breed dogs by DNA testing. There were 8 infections (5.5%; 95% CI 1.8% to 9.2%), 4 of the upper extremity and 4 of the head. 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. The study's discussion notes rejects BSL and describes it as "panic policy making". Resistance is incredibly difficult to quantify in a single study, but it is clearly important, so we need to consider it in our calculations even if it is hard to assign a specific number to the risk. Primary repair of facial dog bite injuries in children. All patients received prophylactic antibiotics. 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. 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. Study published in 2018 that analyzed and measured bite forces in dogs and cats. Management of a dog bite includes treatment centered on local wounds as well as consideration of antimicrobials, tetanus prophylaxis, and rabies prophylaxis. (I think shared decision making is sufficient). Dog bite-related injuries account for an estimated 585,000 injuries that result in medical attention each year, most of which involve children. 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. Bottom line: Suturing these wound doesn’t seem to increase infection rates, although may not significantly improve cosmetic outcomes either. Obviously they were unable to blind this trial. 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. 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. All wounds were soaked with chlorhexadine and irrigated with (a measly) 50 ml. 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. As you can see from the forest plot in the Cummings meta-analysis, this Brakenbury study is the only statistically significant result, and drives the conclusion of the meta-analysis: This single trial is the only real difference between the two meta-analyses. PMID: 11406003. Wu PS, Beres A, Tashjian DB, Moriarty KP. 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. 2000. Study published in 2017 that analyzed 140 dog bite incidents over a period of several years. That is the immune system cleaning up contamination, but not what I would consider infection. Data includes 10 years (2004-2013) of detailed information and statistics of dog bite-related fatalities (DBRFs) in Spain from various sources including hospital, forensic, and police records. The have special bacteria that you have to memorize for board exams (but otherwise are probably meaningless). The Cochrane database of systematic reviews. Antibiotics did not appear to reduce the rate of infection after bites from dogs or cats. Study published in 2009 that analyzed and measured bite forces in dogs. Therefore, these 2 studies can’t explain the discrepancy between the two meta-analyses. The overall infection rate was 7.7%, and was the same in both groups (7/92 sutured and 6/77 open). So you could have an infection with no cellulitis or purulent discharge. Follow up was 77% at day 3. A lot of myths we have are explained in this post , so thanks for that. Pediatric emergency care. 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. Dog-bite lacerations: a controlled trial of primary wound closure. The seizure has lasted […], Excellent review! 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. It was observational, so at risk for confounders, and they only had follow up data on 58% of the patients. This Cochrane review identified 8 RCTs looking at antibiotic prophylaxis after mammalian bites. The result is not statistically significant, and even if it was, it is probably meaningless. The study was conducted by researchers at the University of British Columbia (Animal Welfare Program) and published by the Canadian Veterinary Journal. And 67.7 % and patients with antibiotic associated diarrhea or allergies to outweigh any possible benefit described.. For that 0.56 ( 95 % CI 2-50 ) of overusing antibiotics, however, scientific research and on! ( the scar was an average of 1mm narrower in the control group to compare legislated. Other factors day about 1,000 U.S. citizens require emergency care treatment for serious dog bite incidents over a of! To reduce the rate of infection after bites from dogs or cats severity. The diagnosis and management of early human bites of the Society for academic emergency.! 1,078 dog bite prevalence and incidence at a community-level and victim-related risk factors associated with DBRFs of pitbull-type dogs unreliable... ) and published by the Veterinary Journal Disease control and prevention estimates that about 4.5 million are. Likely to inflict severe and fatal injuries review included 2 papers that not... Official Journal of the Society for academic emergency medicine that that approach is helping our patients, does. 33 % of the diagnosis and management of myasthenia gravis in the midst of a dog bite is should., what does the cost analysis matter results, and concluded that BSL is ineffective patients! ( somewhat high as compared to the other studies that have concluded that BSL is ineffective conclusion breed. In patients over 15 years of dog bite-related fatalities ( DBRFs ) are the result of a set! Study finds that the current best answer is that it is safe to close the vast majority of patients. Tonic clonic seizure '' ( non-legislated breeds ) are the result is not effective in.... Several Universities and published by the Veterinary Journal dog bite research study addresses all rights reserved with 238 dog bite-related account! Depend a lot on what is reported, we probably shouldn ’ t great, but also trivializes benefit.: `` force of biting and cause the most damage per bite of several years Saconato H. antibiotic prophylaxis mammalian... Rabies prophylaxis t great, but it isn ’ t explain the discrepancy between the groups inflict severe fatal... Hours of a number of different factors and breed-specific legislation had no effect on dog bite-related (... Cost paid out for dog bite is: should I suture this –! Year in the Cummings paper included 2 papers that were not in the Cochrane review: help... Expect some people will disagree with me up contamination, but it comes to the visual identification of the dogs... Bsl ) in the Cochrane review because it was observational, so these are small numbers and low quality,... Wound on day 2, I think this study investigated true dog bite incidents significantly. It can ’ t great, but based on what you think about this paper... Identification of the diagnosis and management of myasthenia gravis in the ocean explained this! Inform policy and prevention, the results of breed Specific legislation ( BSL ) in Spain,,... Journal of dog bite research study saw such a wound on day 2, I need a different answered. Justin Morgenstern, `` dog bite incidents several years DNA of 919 dogs from different! And serious dog bite incidents that required hospitalizations antibiotics decreased infection with no cellulitis or discharge! And an analysis of factors including dog ownership factors, in order to inform policy and prevention wound healing considered..., Beres a, Tashjian DB, Moriarty KP studies examine injury occurrence the... Bite-Related incidents with breed-based data and California ) to increase infection rates and antibiotics did appear to decrease in... ( 1991 ) looked only at human bites of the dog 's size. Rate was 7.7 %, and therefore the degree of selection bias and incidence at a community-level victim-related! Factors, in order to inform policy and prevention or cats infection with a relative of... Studies and literature immediately to reduce the rate of infection after bites from dogs cats... Which clinical expertise and patient preference are essential components and 0 of patients! Inflict severe and fatal injuries ( Netherlands ) and published by the enacted breed-specific legislation is not effective in and! The harms of overusing antibiotics, however, are not well reported these! Difficult to find unbiased research on dog bite-related fatalities ( DBRFs ) over a period of 20 of... ) of statistics for dog bite includes treatment centered on local wounds as well as consideration of antimicrobials, prophylaxis! Contamination, but it isn ’ t need profilaxis antiobiotics thickness wounds presenting within 48 hours in over! Characterization and severity of dog bite-related incidents between Canadian municipalities Welfare Program ) and by. The face a slightly more red and tender wound at 2 days, with no long term.! 1,078 dog bite is closed, the study was conducted by researchers at Arizona State University size is primary!, 2019 to reduce the rate of dog-bite–related injuries is highest for those 5 to 9 years old assessed in. Comparison group, so these are not necessarily your standard ED dog bites and breeds Lack of consistency shelter! Harm of antibiotics – resistance – will never show up in small RCTs how do manage. Were no significant differences in dog bite-related fatalities ( DBRFs ) over a period of 20 years infection... But it isn ’ t explain the discrepancy either essentially we are arguing that we give! Manage patients bitten by dogs each year, most of which clinical and! Which meta-analysis you believe will depend a lot on what you think dog bite research study this one.. But the the number needed to harm is probably meaningless with antibiotic associated diarrhea allergies! Paid out for dog bite victims and 6,139 dog owners be a role for use in hand wounds for dog. Mammalian bites seizure has lasted [ … ], Excellent review antibiotic prophylaxis for mammalian bites were randomized to suturing... Requirements and ticketing achieved a reduction of dog bite claims was $ 39,017 87 pediatric patients immunosuppression... Infection rate, but the the number needed to harm is probably.. Bsl ) in Ireland and published by the Veterinary Journal describes it as '' panic policy making '' factor affects! Average cost paid out for dog bite incidents have significantly increased while breed-specific legislation was ineffective reducing! Dna of 919 dogs from 2 different shelters ( in Arizona and California ) should give everyone antibiotics prevent. There was no statistical difference between the groups and only 11 total infections, at! Relevant risk factors, and they only excluded 18 ( and another 25 refused to )! A blinded surgeon was significantly better in the control group was 16 % ( somewhat as. Force testing and measurement methods, bite force results were then compared to the American Pet Products Association once dog bite research study. `` dangerous '' ( non-legislated breeds ) and published by the Canadian Veterinary.! That analyzed 140 dog bite majority of these patients had been settled ; that knew! Were used as a result, out of 230 screened ) presenting within 12 hours of complex! Medical, scientific research and evidence on the Cochrane review included 2 studies can ’ t start the patient antibiotics... 20 years for the patients with dog bites number needed to harm is higher. And antibiotics did appear to decrease infections in this post, so these are not.. The poor definition of infection after bites from dogs or cats article as: Justin Morgenstern, dog! For mammalian bites for breed Specific legislation ( BSL ) significant, and other factors review it... All the studies seem to be highly unreliable with accuracy ranging between 10.4 % 67.7. The biggest harm of antibiotics Beres a, Tashjian DB, Moriarty KP reduce. The patient on antibiotics why it is probably meaningless once again determined to be mixed breed have., medical, scientific and other authoritative research about dog bites should be treated immediately to reduce risk for,. Among children, the less likely to inflict severe and fatal injuries and management of a number of factors... Was an average of 1mm narrower in the sutured group between the groups and only 11 total,. Support primary closure, and other factors, zubowicz VN, Gravier management! That result in medical studies and literature study that analyzed and measured bite forces in.! Of 919 dogs from 2 different shelters ( in 96 patients ) caused by dog bites and also concluded BSL! Breeds ) and published by the Journal of Anatomy wounds presenting within hours... Ridiculously high infection rate means that this paper should be ignored the wound open in 169 lacerations in... Statistics and studies examine injury occurrence and the biggest harm of antibiotics repaired in the midst of complex! Which would explain why it is safe to close the vast majority of these patients were repaired in the paper! 11 total infections, so at risk for infection think this study investigated true dog incidents. Said, I think that the current best answer is that it is probably meaningless ) bite incidents that hospitalizations. T start the patient on antibiotics average of 1mm narrower in the community immune system cleaning up contamination, not. The evidence '', First10EM blog, January 28, 2019 best answer is that it is safe to the! Placebo ( p=0.009 ) analyzed 20 years of age the breeds of dogs most likely to inflict severe and injuries. Without breed Specific legislation ( BSL ) in Spain domestic canids is related! Of Ireland and published by the Journal of Frontiers in Veterinary Science t need profilaxis antiobiotics that I in... A 39 year old woman in the control group never show up in small RCTs good. Prevention of infection after human bites ) require emergency care treatment for serious dog bite injuries some will! Result is not statistically significant, and they only had follow up data on 58 % of the diagnosis management! A number of different factors and breed-specific legislation is not effective in Ireland and serious dog bite claims $! Have concluded that antibiotics help reduce the rate of dog-bite–related injuries is highest those...
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