I concur, Doctor.
I’ve had very good results with amoxicillin/clavulanate for many decades now in outpatient medicine - specifically for foot puncture wounds with and without shoes (nails going through shoes I’ve used 875mg/125mg once daily for 5 days as prophylaxis, twice daily for 7-10 days for gross contamination, lacerations, etc. Ciprofloxacin is a good alternative, or has been for organisms mentioned including pseudomonads. The Sanford Guide is your friend… I’ve carried a copy since 1987 and I could read it without glasses).
From what the OP described, this does sound like a contaminated wound, not just simple “tattooing” from carbon or plant matter/dye.
Best care is I&D/debride as necessary, antibiotics and a Tetanus toxoid booster at least if not DTaP series for a child.
I’ve seen keflex work on C. tetani infection - patient had a skin “rash” from yard work, NP in my clinic Rx’d keflex and sent out a culture (thank God), turned out to be C. tetani and he had never had a vaccine but the wounds healed without complication.
What is “I&D”? Irrigate and debride? That we began tonight and will continue in the morrow. The kid fell asleep before we were finished!
PS, or by the way, I NEVER use hydrogen peroxide on open wounds.
Peroxide does as much tissue damage as it does bacterial action - if any. This leaves devitalized/dead tissue behind as food the remaining bacteria to feast upon.
Despite decades of surgeons, infectious disease and wound care specialists doing their best to prove one agent works better than another for cleansing wounds, what seems to come up a winner - repeatedly, in one study after another - is TAP water (in the US anyway) or just plain fresh water. Boil if you need to knowing that if water comes to a boil, it’s ALL the samme 212F temp and is sufficient to kill most common organisms. Let it cool and use that.
Tap water is chlorinated (which helps), it’s readily available, there’s plenty of it and you can adjust the temperature. Better would be normal saline or pH bufferred, but the general idea is expediency.
But peroxide? In the words of my microbiology professor in med school, “it fizzes and foams and looks like it’s doing somethign but it’s just burning tissue.” Later studies in my career have borne this out.
FWIW.
Clostridium tetani is sensitive to penicillin and therefore to amoxicillin, but it’s the toxin in the tissue that kills.
Most people would at this point give tetanus immunoglobulin as well as vaccine.