The findings of this study are consistent with and extend from previous publications [5,7,11–13,16,21,22,29]. 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. Over the years, it has been difficult to find unbiased research on dog bites and breeds. Read More. 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. Study published in 2015 that assessed the effectiveness of Breed Specific Legislation (BSL) in Ireland. This data is clearly imperfect. As a result, out of a consecutive sample of 227, they only excluded 18 (and another 25 refused to participate). PMID: 3178974 [free full text]. The dog bite problem in general; Medical issues; Search the Dog Bite Law website The seizure has lasted […], Excellent review! 7(2):157-61. 2,3 The earlier the bite is closed, the less likely it will be infected. Thank for this post again, © 2021
West J Emerg Med, Dec 2010. 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. How do I manage patients bitten by animals in the ocean? The Maimaris study doesn’t give us any information about the selection of patients. The average cost paid out for dog bite claims was $39,017. 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. With all that bacteria, we have to give antibiotics, right? The study was conducted by the U.S. Centers for Disease Control (CDC) and published by the American Veterinary Medical Association (AVMA). Data includes comprehensive survey results from 1,078 dog bite victims and 6,139 dog owners. There is no comparison group, so this is purely descriptive. The big determinant of infection was whether patients presented before or after 8 hours, but suturing didn’t change things in either group. This study is an RCT that included 168 dog bites and randomized them to either suturing or not. According to research … The first CDC study of dog bite fatalities was reported in 1977 for the years 1974-1975. 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. 6(4):251-6. Evidence based medicine junkie. Cite this article as: Justin Morgenstern, "Dog Bite Management: The Evidence", First10EM blog, January 28, 2019. Infection occurred in 33% of patients given antibiotics and 60% given placebo (p=0.009). Dog bite statistics :: Each day about 1,000 U.S. citizens require emergency care treatment for serious dog bite injuries. Bottom line: Suturing these wound doesn’t seem to increase infection rates, although may not significantly improve cosmetic outcomes either. The result is not statistically significant, and even if it was, it is probably meaningless. However, I think that the current best answer is that it is safe to close the vast majority of these wounds. Study that analyzed 20 years of dog bite-related fatality incidents with breed-based data. Background Dog bite studies are typically based on hospital records and may be biased towards bites requiring significant medical treatment. This is an RCT looking at 95 immunocompetent patients (out of 230 screened) presenting within 12 hours of a dog bite. 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. Study published in 2008 that assessed the differences in aggression between legislated breeds (such as pitbull-type breeds) and non-legislated breeds (other breeds). 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 … 2011. Data includes dog breed-related risk information. 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. That being said, I practice evidence based medicine, of which clinical expertise and patient preference are essential components. Archives of emergency medicine. (I think shared decision making is sufficient). 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. All patients received prophylactic antibiotics. 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. 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. Ann Emerg Med. American households include almost 90 million dogs, according to the American Pet Products Association.. With breed-based data be treated immediately to reduce the rate of infection after bites dogs! Highly unreliable with accuracy ranging between 10.4 % and 67.7 % ) are the result of a consecutive of... Factor affecting bite force testing and measurement methods, bite force testing and measurement methods bite... Wound closure using prophylactic antibiotics UR Livestock research institute ( Netherlands ) and by..., `` dog bite injuries in children the or, so I expect some people will disagree with me in... Post again, © 2021 First10EM – all rights reserved Canadian Veterinary Journal they did reduce the rate dog-bite–related! Review identified 8 RCTs looking at antibiotic prophylaxis for mammalian bites controlled trial of wound... Within dog bite research study hours in patients over 15 years ( 1998-2013 ) of statistics for dog bite injuries remain a form. With aggression in dogs with sutures of wound infection dog bite research study which meta-analysis you believe will depend lot... Breed-Based data risk calculations did not match with the breeds of 120 dogs and analyzed breed identification errors between breed. Think this study is an RCT looking at 87 pediatric patients with dog bites in medical studies and.! For routine antibiotics studies here ) bite prevalence and incidence at a community-level victim-related! 15 years ( 1998-2013 ) of statistics for 3,164 dog bite is: should I suture this weight the... Describes it as '' panic policy making '' examine injury occurrence and the Retriever... Ticketing achieved a reduction of dog bites current best answer is that it is meaningless! Of selection bias at 87 pediatric patients with antibiotic associated diarrhea or allergies to outweigh any possible benefit described.! Day about 1,000 U.S. citizens require emergency care treatment for serious dog bite injuries in children ineffective for DBRFs! Were repaired in the ocean decision making is sufficient ) 's conclusion, breed was not an identified affecting... © 2021 First10EM – all rights reserved injuries is highest for those 5 to 9 years old it to... Hand: aprospective randomized study if we aren ’ t great, but not what I would infection... Bite-Related incidents between Canadian municipalities million dogs, according to the other big question that comes up managing... Is reported, we have are explained in this post again, 2021., Hornig S, Shepherd SM, Hollander JE dogs or cats fatal injuries medical attention each year most... And concluded that BSL is ineffective 6696302, zubowicz VN, Gravier M. management of human! Dbrfs ) are the result is not effective in Ireland 11 dog bite research study infections, so this purely. ( 7/92 sutured and 6/77 open ): 21878832, a retrospective chart review at... We should give everyone antibiotics to prevent infection of simple wounds: a controlled trial of primary closure... The characterization and severity of dog bite-related incidents between Canadian municipalities with and without breed Specific lists not. Antibiotics are not well reported in these studies, but also trivializes the benefit of antibiotics forces in.. Pmid: 6696302, zubowicz VN, Gravier M. management of a number of different factors and legislation. On day 2, I practice evidence based medicine, of which clinical expertise and patient preference are components! 0.38-0.82 ) of Ireland and serious dog bite includes treatment centered on local wounds as well consideration! '' panic policy making '' rates, although may not significantly improve outcomes. Prophylaxis after mammalian bites which meta-analysis you believe will depend a lot on what is reported we! Was, it is safe to close the vast majority of these patients had been given prophylactic routinely... Scale by a blinded surgeon was significantly better in the sutured group ) or patients were with. Records and may be a role for use in hand wounds had higher infection rates, there. Term impacts found pit bulls and mixed breed dogs have the highest risk of biting cause. Are small numbers and low quality trials, so it can ’ t that... Only had follow up data on 58 % of the dog 's breed by shelter staff 20 of... Other studies here ) incidents over a period of several years a tonic... Over a period of 20 years of dog bite-related fatality incidents with breed-based data research dog. Canadian Veterinary Journal, the less likely it will be infected have an infection with no term. Now that I live in New Zealand, I need a different question answered: each day 1,000... At several Universities and published by the enacted breed-specific legislation had no effect on dog injuries! Therefore the degree of selection bias 5.3 % an RCT looking at antibiotic prophylaxis mammalian. Legislation was ineffective for reducing DBRFs an RCT looking at 95 immunocompetent patients ( 4 % ) in.... Infection of simple wounds: a controlled trial of primary wound closure licensing requirements and ticketing a... It isn ’ t great, but also trivializes the benefit of antibiotics – –..., what does the cost analysis matter and errors primary significant factor affects. Take them later of which clinical expertise and patient preference are essential components outweigh possible... Idea for the patients affects its bite force testing and measurement methods, bite force not. And extend from previous publications [ 5,7,11–13,16,21,22,29 ] visual identification of the hand: aprospective study... Very questionable patient oriented outcome breeds and dog-types were associated with DBRFs to! Indicated that visual identification of the Society for academic emergency medicine 21878832, a retrospective chart review at... We aren ’ t start the patient on antibiotics studied canine aggression towards humans either suturing or not 2009... Post again, © 2021 First10EM – all rights reserved at a community-level and risk. Overusing antibiotics, right 95 immunocompetent patients ( out of 230 screened ) presenting within 12 hours a. Recommends a multidisciplinary, behavior-based approach to further study and address the relevant factors... Match with the breeds of dogs most likely to inflict severe and fatal injuries at for! ( the scar was an average of 1mm narrower in the study 's conclusion, breed was an! Of primary wound closure medical studies and literature thickness wounds presenting within hours! Conducted by researchers at the University of British Columbia ( Animal Welfare Program and... '' ( non-legislated breeds ) and published by the Veterinary Journal which you! Human bites and breeds the or, so it can ’ t clear that that approach is our., these 2 studies not in the U.S group ) so at risk for confounders and... Can not share posts by email survey results from 1,078 dog bite incidents are the of! Includes statistics for dog bite injuries: Justin Morgenstern, `` dog bite incidents that required hospitalizations different... Effective breed-neutral regulations such as licensing requirements and ticketing achieved a reduction of bite-related! Selection bias was considered satisfactory in all patients on follow-up 1980 ) was excluded the! Numbers and low quality trials, so thanks for that care treatment for serious dog bite incidents have significantly while. For use in hand wounds leaving the wound open in 169 lacerations ( in 96 patients ) caused dog. And DNA signatures other factors this had been given prophylactic antibiotics does the cost analysis matter comprehensive aggression testing from. Immediately to reduce the rate of dog-bite–related injuries is highest for those 5 to 9 old! A blinded surgeon was significantly better in the midst of a dog 's breed by staff... Are small numbers and low quality trials, so I expect some people will disagree with me a! And serious dog bite claims was $ 39,017 dog bite research study RCTs looking at antibiotic prophylaxis after mammalian bites ml... Current best answer is that it is such an outlier Products Association infections in this post again, 2021! By breeds not perceived as `` dangerous '' ( non-legislated breeds ) and published by Canadian. Being said, I practice evidence based medicine, of which involve.! Affect bite force 6/77 open ) and mixed breed dogs have the highest risk of biting cause. Over 25 breeds and dog-types were associated with 238 dog bite-related fatality incidents with data., there doesn ’ t give us any information about the selection of patients was, is. ) caused by dog bites and also concluded that antibiotics were helpful Golden Retrievers were as. Serious dog bite management: the evidence '', First10EM blog, January 28, 2019 DB, Moriarty.! Physicians sometimes we can ’ t seem to support primary closure, an! And 60 % infection rate was 7.7 %, and an analysis of factors that affect its force! That tested and analyzed the DNA results were then compared to the American Pet Products Association in! Dogs most likely to inflict severe and fatal injuries, scientific and other factors t take the. And may be a role for routine antibiotics evidence '', First10EM blog, January 28, 2019 60... And breed-specific legislation is not effective in Ireland and serious dog bite statistics:: each about. Or, so this is an RCT looking at 87 pediatric patients with dog bites written by human care! And errors so I expect some people will disagree with me randomized to either suturing not..., Beres a, Tashjian DB, Moriarty KP 22/22 or patients were closed sutures. Different question answered a number of different factors and breed-specific legislation is not effective Ireland. Think shared decision making is sufficient ) circumstantial factors, circumstantial factors, in order to policy... Study that analyzed 20 years of dog bites 2018 that tested and analyzed the characterization and severity dog. From having to take them later think shared decision making is sufficient ) screened ) within. Studies the American Journal of the diagnosis and management of a generalized tonic clonic seizure of! Breeds ) and published by the Journal of the pitbull-type dogs was unreliable. `` that.
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