American Board of Internal Medicine (ABIM) Certification Practice Exam

In which scenario is antibiotic prophylaxis for dog bites particularly indicated?

1. Patients with minor abrasions on the leg

2. Patients with infections already present

3. Patients who are immunosuppressed

4. Patients with referenced skin allergies

The correct answer is: Patients who are immunosuppressed

Antibiotic prophylaxis for dog bites is particularly indicated in patients who are immunosuppressed due to their compromised immune systems. In such individuals, the risk of developing a severe infection following a dog bite is significantly higher, as their bodies may not effectively fight off pathogens that can enter through the wound. This makes it essential to provide prophylactic antibiotics to prevent potential complications that could arise from even minor injuries. In contrast, patients with minor abrasions on the leg typically do not require prophylaxis, as healthy individuals can usually manage potential infections effectively without intervention. Those who already have infections present would need treatment for their current condition rather than prophylaxis for additional infection prevention. Lastly, while individuals with skin allergies might have skin sensitivities or reaction risks, this does not correlate with the need for antibiotic prophylaxis following dog bites. The primary focus is on the immune status of the patient, making immunosuppressed individuals the most at risk and in need of preventative antibiotics.