CAT BITE Antibiotic Prophylaxis for the Hand/Forearm (CATBITE)
Status:
Not yet recruiting
Trial end date:
2026-09-01
Target enrollment:
Participant gender:
Summary
Cat bites are puncture wounds that have the potential to seed bacteria deep within the joint
capsule, periosteum, and bone. The hand is the most common site of bite injuries. Pasteurella
multocida is the is the most common organism isolated from the mouths of cats that can cause
infections after a bite. Prophylactic antibiotics are often recommended with
amoxicillin-clavulanate for 3-5 days to decrease the incidence of developing an infection.
However, only one randomized controlled clinical trial consisting of 12 patients has been
performed to justify this course of treatment, raising the possibility that the use of
antibiotics could be reduced or even eliminated. Investigators will compare different
durations of prophylactic antibiotics and a placebo control for cat bites to the hand/forearm
presenting to the Emergency Department, Urgent Care, Plastic Surgery Clinic using a
randomized, controlled, double-blind clinical trial. Participants presenting to the
University of Missouri Hospital Emergency Department, Missouri University (MU) Healthcare
Urgent Care, Plastic Surgery Clinic over the next year will be offered the chance to enroll
if they meet the inclusion/exclusion criteria. For inclusion, participants will be >18 years
of age, have cat bites to the hand or distal to elbow, and present within 24 hours of the cat
bite injury. Participants must not present with active local or systemic infections, have
received antibiotics within the past 30 days, or be immunocompromised (primary and secondary
immunodeficiencies). Participants will be randomized to one of three treatment arms (placebo;
amoxicillin-clavulanate 1 day; amoxicillin-clavulanate 5 days). Outcomes are the development
of an infection at the location of the cat bite and/or systemic infection, adverse effects of
interventions, disability assessed by Quick Disabilities of Arm, Shoulder and Hand
(QuickDASH) scores, and quality of life (QOL) assessed by HAND Questionnaire (HAND-Q) scores.
Infection will be assessed at day 0, day 2, day 7+/-2, day 15+/-2, and day 30+/-2 by vital
signs, laboratory values, physical examination and with an infrared and digital camera. All
measures will be within the standard of care, apart from the infrared camera, QuickDASH, and
HAND-Q scores. The anatomic locations of cat bites to the hand/forearm will be assessed for
correlations with infections.