What are the recommended post-exposure prophylaxis protocols for patients who have been bitten by a potentially rabid animal?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For high-risk exposures, such as severe and multiple bites to the head and neck or from a confirmed rabid animal, treatment should ideally be started within 12 hours of reporting .

The mainstay of post-exposure treatment is the rabies vaccine given by intramuscular injection at 0, 3, 7, and 21 days .

Human rabies immunoglobulin (HRIG) may provide short-term immunity in the first week following treatment initiation .

It is important that vaccination and human rabies immunoglobulin are never given at the same anatomical site, and vaccine doses are administered in alternate arms .

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