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Cochrane corner: antibiotic prophylaxis for mammalian bites (intervention review)

Background: Bites by mammals are a common problem and they account for up to 1% of all visits to hospital emergency rooms. Dog and cat bites are the most common, and people are usually bitten by their own pets or by an animal known to them. School-age children make up almost a half of those bitten. Prevention of tetanus, rabies and wound infection are the priorities for staff in emergency rooms. The use of antibiotics may be useful to reduce the risk of developing a wound infection. Objectives: To determine if the use of prophylactic antibiotics in mammalian bites is effective in preventing bite-wound infection. Search methods: Relevant randomized controlled trials (RCTs) were identified by electronic searches of MEDLINE, EMBASE, LILACS and the Cochrane Controlled Trials Register databases in November 2000. Selection criteria: We included randomized controlled trials that studied patients with bites from all mammals. Comparisons were made between antibiotics and placebo or no intervention. The outcome of interest was the number of infections at the site of the bite. Data collection and analysis: Two reviewers extracted the data independently. All analyses were performed according to the intention-to-treat method.