The Incidence of Infection Complicating Snakebites in Tropical Australia: Implications for Clinical Management and Antimicrobial Prophylaxis

Table 3

Characteristics of the six patients in the cohort who were diagnosed with infection following the snakebite.

Case	Age, gender	Delayed presentation^a	Received empirical antibiotics at presentation	Clinical signs of infection at presentation	Signs of infection at the bite site^b	Other signs of infection	Envenomation^c	Snake	Antibiotics	Microbiological isolates
1	39, male	No	Yes	No	Warmth and erythema	Inguinal lymphadenopathy pain	Yes: 1 ampoule polyvalent antivenom	Taipan^d (Oxyuranus genus)	Doxycycline (oral), metronidazole (oral)	No
2	16, male	No	Yes	No	Erythema	Pain	Yes: 1 ampoule taipan antivenom	Taipan^d (Oxyuranus genus)	Flucloxacillin (oral)	No
3	50, male	Yes	Yes	Yes	Erythema	No	Yes: 2 ampoules polyvalent antivenom	Taipan^d (Oxyuranus genus)	Piperacillin and tazobactam	No^e
4	4, female	No	No	No	Erythema	Local swelling, inguinal lymphadenopathy	No	Unknown	Cephalexin (oral)^f	No
5	50, female	No	Yes	No	Warmth and erythema	Local swelling	No	Unknown	Flucloxacillin	No
6	45, female	No	Yes	No	Warmth and erythema	Local swelling, pain, axillary lymphadenopathy	No	Carpentaria whip snake Cryptophis boschmai^g	Flucloxacillin	No

^aGreater than 8 hours after bite. ^bAt any point during the episode. ^cContemporary opinion of clinical toxicologist. ^dBased on opinion of clinical toxicologist informed by clinical and laboratory findings, geographical location of the bite, and pathological envenomation syndrome. ^eSuperficial swab sent, no growth. ^fRepresented with worsening pain and erythema same day of discharge, kept overnight for intravenous flucloxacillin and discharged on oral flucloxacillin. No reported complications. ^gConfirmed by zoologist.