However, prevention of infection is a very questionable patient oriented outcome. The seizure has lasted […], Excellent review! 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. 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. West J Emerg Med, Dec 2010. 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. All patients received prophylactic antibiotics. 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. ... case studies… PubMed PMID: 6696302, Zubowicz VN, Gravier M. Management of early human bites of the hand: aprospective randomized study. The study was conducted by the U.S. Centers for Disease Control (CDC) and published by the American Veterinary Medical Association (AVMA). This Cochrane review identified 8 RCTs looking at antibiotic prophylaxis after mammalian bites. 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 … 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. The DNA results were then compared to the visual identification of the dog's breed by shelter staff. Study published in 2017 that analyzed the characterization and severity of dog bites in medical studies and literature. Primary closure versus non-closure of dog bite wounds. All patients received prophylactic antibiotics. Dog bite incidents are the result of a complex set of factors including dog ownership factors, circumstantial factors, and other factors. PMID: 21293762 [free full text]. 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. However, scientific research and evidence on the subject is scattered and sparse. According to research … 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. Study published in 2013 that analyzed 10-years of dog bite-related incidents with breed-based data. ), Unfortunately, now that I live in New Zealand, I need a different question answered. Researchers found pit bulls and mixed breed dogs have the highest risk of biting and cause the most damage per bite. 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. 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. Specifically, this study concludes: "Comparing the results of golden retrievers and breeds affected by the legislation, no significant difference was found. The study's discussion notes rejects BSL and describes it as "panic policy making". Overview. Dog bites should be treated immediately to reduce risk for infection. Bottom line: Based on this Cochrane review, there doesn’t seem to be a role for routine antibiotics. These are small numbers and low quality trials, so I expect some people will disagree with me. Primary repair of facial dog bite injuries in children. Data includes statistics for breed identification errors between visual breed identification and DNA signatures. A randomized controlled trial comparing primary closure to leaving the wound open in 169 lacerations (in 96 patients) caused by dog bites. All rights reserved. Study published in 2015 that assessed the effectiveness of Breed Specific Legislation (BSL) in Ireland. Read More. The average cost paid out for dog bite claims was $39,017. That is certainly how I was taught, but it isn’t clear that that approach is helping our patients. Infection occurred in 33% of patients given antibiotics and 60% given placebo (p=0.009). Annually, about 14,025 citizens are hospitalized due to dog bite injuries. 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. 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. Data includes dog breed-related risk information. 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 … 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. 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. After confirming that the victim is medically stable, physicians should begin a primary assessment by taking a history. Zubowicz (1991) looked only at human bites and also concluded that antibiotics help. A lot of myths we have are explained in this post , so thanks for that. 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. As a result, out of a consecutive sample of 227, they only excluded 18 (and another 25 refused to participate). Case Reports & Presentations Golden Retrievers were used as a control group to compare the legislated breeds against. 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. Dog bites by breeds not perceived as "dangerous" (non-legislated breeds) are less likely to be reported. A rapid review of the diagnosis and management of myasthenia gravis in the emergency department. Note: This study is not peer-reviewed; however, it is included because of its comprehensive, verifiable data set (hospital records) and its inclusion in The Veterinary Journal. Evidence based medicine junkie. They are talking about a slightly more red and tender wound at 2 days, with no long term impacts. Wu PS, Beres A, Tashjian DB, Moriarty KP. 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. reported higher bite ratios than handlers with “bite and hold” trained dogs. Harms from antibiotics are not well reported in these studies, but the the number needed to harm is probably higher than 4. 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. Behavior such as teasing the dog comes to mind as a top reason: other studies show that in most dog bite … (I think shared decision making is sufficient). PMID: 2692580 [free full text]. 2014; 45(1):237-240. PMID: 3178974 [free full text]. 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. This study is an RCT that included 168 dog bites and randomized them to either suturing or not. The study agrees with other studies that have concluded that BSL is ineffective. Infection in the control group was 16% (somewhat high as compared to the other studies here). I am not sure that makes any sense. This is always the big question. 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. Management of a dog bite includes treatment centered on local wounds as well as consideration of antimicrobials, tetanus prophylaxis, and rabies prophylaxis. Medeiros I, Saconato H. Antibiotic prophylaxis for mammalian bites. The have special bacteria that you have to memorize for board exams (but otherwise are probably meaningless). 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. "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). The issue of dog bites and dog aggression directed at humans is frequently in the media. Breed-specific legislation had no effect on dog bite-related injuries. The result is not statistically significant, and even if it was, it is probably meaningless. 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. [pubmed]. The Paschos study is a good RCT with broad inclusion, but could be underpowered for a small difference between the groups. Among children, the rate of dog-bite–related injuries is highest for those 5 to 9 years old. We explain first aid tips for dog bite treatment at home, plus signs of infection and … Using appearance to determine breed was once again determined to be highly unreliable with accuracy ranging between 10.4% and 67.7%. Study that analyzed 20 years of dog bite-related fatality incidents with breed-based data. All wounds were soaked with chlorhexadine and irrigated with (a measly) 50 ml. Annals of emergency medicine. There were no significant differences in aggression between the legislated breed group and the Golden Retriever control group. Elenbaas RM, McNabney WK, Robinson WA. 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)…. 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. In the study's conclusion, breed was not an identified factor affecting bite force. The Centers for Disease Control and Prevention estimates that about 4.5 million people are bitten by dogs each year in the U.S. All of these patients had been given prophylactic antibiotics. PMID: 21878832, A retrospective chart review looking at 87 pediatric patients with dog bites to the face. 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. The first CDC study of dog bite fatalities was reported in 1977 for the years 1974-1975. However, more than ½ of these patients were repaired in the OR, so these are not necessarily your standard ED dog bites. Municipalities that enforced effective breed-neutral regulations such as licensing requirements and ticketing achieved a reduction of dog bite incidents. 7(2):157-61. 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 . Case EMS arrives with a 39 year old woman in the midst of a generalized tonic clonic seizure. Patient on antibiotics to support dog bite research study closure, although there are some significant limitations were repaired the! ) 50 ml 1984 ) looked only at human bites of the patients there was no statistical difference between legislated. Was, it is safe to close the vast majority of these wounds not sent - check your addresses! 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