Rabies Post-Exposure Prophylaxis, What the U.S. Emergency Medicine Provider Needs to Know.

Approximately 55,000 patients per year in the United States are exposed to potentially rabid animals and receive rabies post-exposure prophylaxis (PEP) and these patients commonly present to the emergency department for wound care and PEP. Despite the number of rabies exposures seen in emergency departments each year, there appears to be a knowledge gap among healthcare providers with regard to prescribing and administering rabies PEP. The following review aims to bridge that knowledge gap by discussing the importance of obtaining a comprehensive exposure history to determine the category of the encounter, the type of animal, the location of the bite, and outside expert resources to determine whether the rabies PEP series is indicated. In addition, this article will discuss dosing, administration and schedule of the rabies vaccine and human rabies immune globulin to ensure patients are fully protected from developing rabies. Lastly, this article discusses the potential cost associated with rabies PEP and provides information on managing this barrier.