Management of Centipede Bite

Immediate First Aid Measures

Apply ice or cold compresses to the bite site for 10-20 minutes to reduce local pain and swelling, as recommended by the American Academy of Allergy, Asthma, and Immunology 1, 2, 3
Place a thin towel barrier between the ice and skin to prevent cold injury, according to the American Heart Association 4
Administer acetaminophen (15 mg/kg) or ibuprofen (10 mg/kg) for systemic pain control, as suggested by the American Heart Association 3

Irrigate the bite site liberally with copious amounts of water or saline to remove any venom and reduce infection risk, as recommended by the American Heart Association 4, 5
Clean thoroughly but avoid harsh antiseptics that may damage tissue, according to the American Academy of Pediatrics 5

Call emergency services immediately if the child develops difficulty breathing or respiratory distress, altered mental status, confusion, or decreased responsiveness, muscle rigidity or severe systemic symptoms, or signs of severe allergic reaction, as advised by the American Heart Association 3 and the American Academy of Allergy, Asthma, and Immunology 1, 2

Antibiotics are NOT routinely indicated for centipede bites, as the initial reaction is due to venom toxicity, not infection, according to the American Academy of Allergy, Asthma, and Immunology 1, 2
Consider antibiotics only if secondary bacterial infection develops, and amoxicillin-clavulanate is first-line, as suggested by the Infectious Diseases Society of America 5
Ensure tetanus immunization is current, and administer 0.5 mL DTaP intramuscularly if the child's vaccination status is incomplete or unknown, as recommended by the Centers for Disease Control and Prevention 5

Do NOT apply suction devices, as these are ineffective and may worsen tissue damage, according to the American Heart Association 4
Do NOT apply pressure immobilization bandages, unlike snake bites, this is not indicated for centipede bites, as advised by the American Heart Association 4
Do NOT prescribe prophylactic antibiotics, as the swelling is from venom-induced inflammation, not infection, according to the American Academy of Allergy, Asthma, and Immunology 1, 2