How many days after a tick bite should immunoglobulin be administered? - briefly
Administer immunoglobulin as soon as possible, preferably within the first 24 hours after the bite. Treatment remains effective if given up to seven days post‑exposure.
How many days after a tick bite should immunoglobulin be administered? - in detail
Immunoglobulin for rabies exposure must be given as soon as possible after the tick bite that is suspected to involve a rabid animal. The recommended window is within the first week following the incident; administration on the same day is ideal. If the first dose of vaccine has already been started, the immunoglobulin should be given no later than the seventh day after that initial vaccine dose. Delayed administration beyond this period is discouraged but may still be considered if the exposure risk remains high and no other prophylaxis has been provided.
Key points for proper use:
- Timing – Immediate injection after exposure; preferably before day 7 of the vaccine series.
- Dosage – 20 IU per kilogram of body weight, infiltrated around the wound site as fully as possible; any remaining volume is injected intramuscularly at a separate site.
- Vaccine schedule – Four doses of rabies vaccine on days 0, 3, 7, and 14 (or a five‑dose schedule with an additional dose on day 28 for certain regimens). The immunoglobulin is administered only once, concurrent with the first vaccine dose.
- Wound care – Thorough washing with soap and water, followed by antiseptic irrigation, before immunoglobulin injection.
- Product choice – Human rabies immunoglobulin (HRIG) is preferred; equine-derived products (ERIG) may be used when HRIG is unavailable, with appropriate monitoring for allergic reactions.
- Special populations – Children receive the same weight‑based dose; immunocompromised patients should still receive immunoglobulin, but may require additional vaccine doses for adequate protection.
- Contraindications – Known hypersensitivity to immunoglobulin preparations; otherwise, the product is safe for all age groups.
If the bite occurred more than seven days after the first vaccine dose, the immunoglobulin is generally omitted, and the vaccine series continues according to the standard schedule. Immediate medical evaluation is essential to assess the need for immunoglobulin and to initiate the full post‑exposure prophylaxis protocol.