Question of the Week

For May 22, 2018

An 8-year-old boy is brought to the emergency department (ED) by his parents one hour after an unknown dog bit him in the right lower leg. An animal control form was completed in triage.

His medical history is unremarkable, except for an episode of rash and difficulty breathing that occurred when he received amoxicillin a few years ago. He is up-to-date with his immunizations, having received his last set before entering kindergarten at age 5 years.

His vital signs are stable, and he appears well. He has a 10-cm semicircular laceration on the right lower leg and several puncture wounds beneath it. There is no surrounding erythema, warmth, or drainage. No tissue is missing or devitalized, but the wound is large enough to require suturing.

What is the most appropriate antimicrobial management for this patient?

Amoxicillin only
Clindamycin only
Trimethoprim–sulfamethoxazole plus clindamycin
Trimethoprim–sulfamethoxazole only
Amoxicillin–clavulanate