Retrospective evaluation of children immunized against rabies in a pediatric emergency department

Objective: Rabies is a fatal disease of the central nervous system. This study aimed to evaluate post-exposure rabies prophylaxis practices in a tertiary pediatric emergency department. Materials and Methods: In this retrospective observational study, the characteristics of patients aged 0-18 years who presented to the pediatric emergency due to a rabies-risk exposure and received rabies vaccination between March 1, 2023 and March 1, 2025 were examined. Patients whose first dose of rabies vaccine was administered at another center were excluded.Data were obtained by reviewing the hospital information management system and the rabies vaccination registry in which rabies vaccines were recorded. The patient’s demographic and clinical characteristics and data regarding risky exposures were recorded in the data collection form as study parameters. Results: A total of 2155 patients who received post-exposure prophylaxis were included in the study. The mean age of the patients was 105.7±60.7 months. Of the patients, 74.7% presented after contact with a cat and 24% after contact with a dog. The most common site of risky exposure was the upper extremity (56.8%), and the most common type of injury was scratching (69.7%). Head and neck injuries were significantly more frequent in exposures occurring at home (p<0.001) and differed significantly across age groups (p<0.001), decreasing with increasing age. Exposures most commonly involved animals that were stray (83.8%), unvaccinated (91.1%), and unobservable (83.2%). It was observed that 49.3% of patients completed the rabies vaccination schedule as recommended. Rabies immunoglobulin was administered to 12.7% of patients, local wound care to 6.9%, tetanus vaccine to 30.4%, antibiotics to 13.4%, and suturing was performed in 1.5%. Conclusion: Rabies-risk exposures most commonly occur with unowned stray animals. Injuries to high-risk regions such as the head and neck may be more common, particularly in young children and in exposures involving household animals.