Prospective evaluation of the incidence of wound infection in rattlesnake envenomation in dogs

Objective To evaluate the incidence of wound infection following crotalidae envenomation in dogs and determine if the use of prophylactic antibiotics is warranted. Design Prospective observational study. Setting A 24‐hour private practice specialty and emergency center in Murrieta, California. Animals One hundred and two dogs with acute rattlesnake envenomation. Interventions One hundred and forty‐three consecutive cases of suspected acute rattlesnake envenomation were evaluated between March of 2012 and May of 2013. One hundred and two cases received no antimicrobials as part of management. Eight cases were placed on prophylactic antimicrobials by the primary care veterinarian prior to referral and were excluded. Two cases were excluded because they were initiated on antimicrobials during hospitalization for reasons unrelated to snakebite. Three cases involved cats and were excluded. Three patients died acutely near the time of presentation and were excluded. Twenty‐one cases of suspected envenomation were excluded for lack of strong evidence of snakebite. Four cases were lost to follow‐up and were excluded. Follow‐up was conducted within 2 weeks either by phone or by direct inspection of the wound. Results Of the 102 patients included in the study only 1 infection developed. This patient developed an abscess subsequent to suspected compartment syndrome. Conclusion The incidence of wound infection in rattlesnake envenomation is low, and the use of prophylactic antimicrobials is not recommended. The use of antimicrobials should be reserved for wounds with necrosis or abscess and the choice of antimicrobial should be based on a culture and sensitivity of the wound.