DOG BITES IN CHILDREN

How significant are dog bites in children?

Dog bites represent an important healthcare problem ranging from trivial to fatal injuries, often unappreciated by the general public. The majority of victims are children.

How common are dog bites?

Many bites go unreported making the precise incidence impossible to measure. It is estimated that at least 1 million people suffer from mammalian bites each year in the North America. Dog bites account for 80-90% of these injuries with the remainder being caused by cats (5-10%), rodents (2-3%), and humans (2-3%). Although most victims never seek medical care, dog bites still account for approximately 1% of Emergency Department visits.

Which children are most commonly affected? Which dogs?

Children under 12 years account for 50% of dog bites. Children under 5 years of age account for the majority of severe dog bites. Large breed dogs account for most of the bites and German Shepherds or German Shepherd mixes are the most common breed. Most victims are familiar with the dog and the most common location is in a house, in the child’s neighbours yard or in the neighbourhood itself. Over 80% of bites tend to affect the head and neck while the trunk and extremities are involved in 40% of cases.

How can dog bites be prevented?

Both dog owners and adults who care for children must be educated to the range of situations and behaviors that elicit aggressive responses from dogs. Parents must teach their children to treat all animals with respect, which includes never hurting, teasing or taking things from dogs. Infants and toddlers must never be left alone with a dog. Consultation with a veterinarian should be sought whenever questions of aggression in a dog appear. Dogs with prior histories of attacking humans should be appropriately handled and retrained.

Should prophylactic antibiotics be used when treating dog bites?

There is no good evidence that the use of prophylactic antibiotics makes a significant difference in the outcome of dog bite injuries except when certain risk factors exist (e.g., location on the hand, deep puncture wounds or immunocompromised host). The choice of antibiotic is simple in dog bite wounds. Coverage must include Streptococcus, Staphylococcus aureus, S epdermidis, and S intermedius. Pasturella is rare in dog bite wounds. Therefore, cephalexin or dicloxacillin (Erythromycin for the penicilllin allergic patient) would constitute good and cost effective treatment when required.

References

1. Brogan TV et al.. Pediatrics, 96; 947-950, 1995.

2. Gershman KA et al. Pediatrics 93: 913-917, 1994.

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