146.2 📚 國考版

146.2.0.1 必背 — 病原 by Source

• Cat: Pasteurella multocida (#1)
• Dog: Pasteurella canis, Capnocytophaga (asplenic!)
• Human fight bite: Eikenella corrodens
• Bat: rabies!
• Cat scratch: Bartonella

146.2.0.2 必背 — Empirical Antibiotic

• Amoxicillin-clavulanate (Augmentin) = covers most
• PCN allergy: doxycycline OR moxifloxacin OR TMP-SMX + metro/clinda

146.2.0.3 必背 — Rabies PEP

• Not previously vaccinated: HRIG 20 IU/kg + 4-dose vaccine (Day 0, 3, 7, 14)
• Previously vaccinated: 2-dose vaccine (Day 0, 3); NO HRIG
• Bat exposure in sleeping room: PEP even without visible bite

146.2.0.4 必背 — Tetanus

• < 10 yr booster: no boost

• 10 yr or unknown: Tdap (+ TIg if dirty)

146.2.0.5 必背 — Prophylaxis Indications

• Cat / human bite (any)
• Hand / face / genital / foot bite
• Crush / deep
• Immunocompromised / DM / asplenic

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