In dogs with snakebites does the use of antimicrobials compared to no antimicrobials reduce incidence of wound infection?
Clinical bottom line
Category of research
Number and type of study designs reviewed
Seven case series.
Strength of evidence
Three studies looked at the incidence of wound infection in envenomated dogs, three compared antimicrobial use to mortality and one compared other outcomes, such as time in hospital. The incidence of wound infection was low in the studies and overall antimicrobials seemed to have no significant effect on outcomes such as survival or wound infection. Therefore, the routine use of antimicrobials for snakebite treatment is not supported by the results, however further studies are required to provide conclusive evidence.
There is currently insufficient evidence from literature to either support or reject the use of antimicrobials in the treatment of snakebites.
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
Armentano, R.A. & Schaer, M. (2011). Overview and controversies in the medical management of pit viper envenomation in the dog. Journal of Veterinary Emergency and Critical Care. 21(5), 461–470. DOI: https://doi.org/10.1111/j.1476-4431.2011.00677.x
August J.A., Boesen K.J., Hurst N.B., Shirazi F.M. & Klotz S.A. (2018). Prophylactic Antibiotics Are Not Needed Following Rattlesnake Bites. The American Journal of Medicine. 131(11), 1367–1371. DOI: https://doi.org/10.1016/j.amjmed.2018.06.006
Bhaumik S., Gopalakrishnan, M., Kirubakaran, R. & Jagnoor, J. (2022). Antibiotics for preventing wound infections after snakebite. Cochrane Database of Systematic Reviews 2022. 7. DOI: https://doi.org/10.1002/14651858.CD015114
Carr, A. & Schultz, J. (2015). Prospective evaluation of the incidence of wound infection in rattlesnake envenomation in dogs. Journal of Veterinary Emergency and Critical Care. 25(4), 546–551. DOI: https://doi.org/10.1111/vec.12337
Hackett, T.B., Wingfield, W. E., Mazzaferro, E.M. & Benedetti, J.S. (2002). Clinical findings associated with prairie rattlesnake bites in dogs: 100 cases (1989–1998). Journal of the American Veterinary Medical Association. 220(11), 1675–1680. DOI: https://doi.org/10.2460/javma.2002.220.1675
Lervik, J., Lilliehöök, I., Frendin, J., 2010). Clinical and biochemical changes in 53 Swedish dogs bitten by the European adder – Vipera berus. Acta Veterinaria Scandinavica, 52(12), DOI: https://doi.org/10.1186/1751-0147-52-26
Kim, D., Kim, S., Kim, J., Lim, J.H., Choi, G., Bae, S., Kwon, Y. & Jang, M. (2022). Clinical features and management of snake bites in 70 dogs in Korea. Journal of Veterinary Science. 23(6). DOI: https://doi.org/10.4142/jvs.22105
Malina, T., Krecsák, L., Westerström, A., Szemán-Nagy, G., Gyémánt, G., M-Hamvas, M., Rowan, E., Harvey, A., Warrell, D., Pál, B., Rusznák, Z. & Vasas, G. (2017). Individual variability of venom from the European adder (Vipera berus berus) from one locality in Eastern Hungary. 135,59–70. DOI: https://doi.org/10.1016/j.toxicon.2017.06.004
McCown, J.L., Cooke, K.L., Hanel, R.M., Jones, G.L. & Hill, R.C. (2009). Effect of antivenin dose on outcome from crotalid envenomation: 218 dogs (1988–2006). Journal of Veterinary Emergency and Critical Care. 19(6), 603–610. DOI: https://doi.org/10.1111/j.1476-4431.2009.00487.x
Peterson, M. (2006). Snake bite: Pit Vipers. Clinical Techniques in Small Animal Practice.,21(4), 174–182. DOI: https://doi.org/10.1053/j.ctsap.2006.10.008
Pritchard, J.C., Birkenheuer, A.J., Hanel, R.M. & Wood, M.W. (2014). Copperhead (Agkistrodon contortrix) Envenomation of Dogs: 52 cases (2004–2011). Journal of the American Animal Hospital Association. 50(5), 338–344. DOI: https://doi.org/10.5326/jaaha-ms-6131
Sutton, N.M., Bates, N. & Campbell, A. (2011). Canine adder bites in the UK: a retrospective study of cases reported to the Veterinary Poisons Information Service. Veterinary Record.169(23), DOI: https://doi.org/10.1136/vr.d4695
Witsil, A.J., Wells, R.J., Woods, C. & Rao, S. (2015). 272 cases of rattlesnake envenomation in dogs: Demographics and treatment including safety of F(ab′)2 antivenom use in 236 patients. Toxicon. 105, 19–26. DOI: https://doi.org/10.1016/j.toxicon.2015.08.028
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