Analysis of antibiotic resistant infections associated with hirudotherapy
Research article published in American journal of otolaryngology (2024)
Abstract
OBJECTIVE: Given rising concern regarding antibiotic resistance, our objective was to evaluate antibiotic-resistant infections following leech therapy and to characterize the use of prophylactic antibiotics. METHODS: All reports of adverse events involving hirudotherapy (product code "NRN") were retrieved from the U.S. Food and Drug Administration MAUDE database between 2012 and 2021. Antibiotic resistance was defined by bacterial culture or infection after antibiotic administration. RESULTS: Nineteen cases of antibiotic resistance involving hirudotherapy were identified. Only three cases of antibiotic resistance were discovered on routine testing and the remaining 16 cases were associated with patient injury. Positive blood cultures or fever were present in 26.3 % (n = 5) of cases. Cultures of the infection grew Aeromonas hydrophilia (n = 13; 68.4 %), Vibrio vulnificus (n = 3; 15.8 %), Pseudomonas aeruginosa (n = 2; 10.5 %), and Proteus vulgaris (n = 1; 5.3 %). There were nine (47.4 %) multi-drug resistant infections. Infection was most commonly resistant to fluoroquinolones (n = 9; 47.4 %), trimethoprim-sulfamethoxazole (n = 9; 47.4 %) and ertapenem (n = 4; 21.1 %). CONCLUSION: Antibiotic-resistant infections involving hirudotherapy are frequently resistant to multiple drugs, including fluoroquinolones and trimethoprim-sulfamethoxazole. Resistance to ertapenem, a drug of last resort, was also documented. The findings presented in this study support growing literature that the trend in multi-drug resistance is more severe than previously reported.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Given rising concern regarding antibiotic resistance, our objective was to evaluate antibiotic-resistant infections following leech therapy and to characterize the use of prophylactic antibiotics.
Why This Matters for Hirudotherapy
This study analyzed adverse event reports from the U.S. Food and Drug Administration MAUDE database (2012–2021) to evaluate antibiotic-resistant infections following leech therapy and characterize prophylactic antibiotic use, identifying 19 cases of resistance with infections caused by Aeromonas hydrophila, Vibrio vulnificus, Pseudomonas aeruginosa, and Proteus vulgaris. These findings are directly relevant to hirudotherapy safety, documenting multi-drug resistance—including resistance to ertapenem, described in the abstract as a drug of last resort—in bacterial infections associated with medicinal leech use. The analysis is limited to 19 cases retrieved from an adverse event reporting system, and the abstract provides no denominator data or incidence rates to quantify overall infection risk. This study raises an important safety signal for practitioners but cannot establish population-level resistance prevalence associated with hirudotherapy.
Citation
Analysis of antibiotic resistant infections associated with hirudotherapy.
Brauer P et al. · American journal of otolaryngology, 2024
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