American Society of Hirudotherapy

Ciprofloxacin-resistant Aeromonas hydrophila infection following leech therapy

Case report/review published in J Plast Reconstr Aesthet Surg (2012)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportAntimicrobial ResistanceSafety & Infection ControlPatel KM et al. · Journal of plastic, reconstructive & aesthetic surgery, 2012

Abstract

Compromised flap perfusion can lead to the use of leech therapy to aid in flap salvage. Aeromonas hydrophila, a symbiont of the leech, is a well-known bacterial pathogen that has the potential to cause infection in patients receiving leech therapy. Ciprofloxacin is commonly regarded as the antibiotic of choice for prophylaxis against this pathogen. We present patient who underwent leech therapy during salvage attempts for a venous congested flap. A resultant infection developed despite being on appropriate antibiotics. Culture sensitivities indicated that A. hydrophila was resistant to ciprofloxacin.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal ArticleReview
Indexed MeSH termsAeromonas hydrophilaAnti-Bacterial AgentsAntibiotic ProphylaxisAztreonamCiprofloxacinDrug Resistance, BacterialFemaleGram-Negative Bacterial InfectionsHumansLeechingMiddle Aged

Summary

Patient with venous-congested flap developed ciprofloxacin-resistant A. hydrophila infection despite appropriate prophylaxis. Review of literature on emerging resistance.

Why This Matters for Hirudotherapy

This case report describes a patient who developed an Aeromonas hydrophila infection during leech therapy for a venous congested flap, despite receiving what was considered appropriate ciprofloxacin prophylaxis. Culture sensitivities confirmed the A. hydrophila strain was resistant to ciprofloxacin, the commonly regarded antibiotic of choice for prophylaxis against this pathogen. This is directly relevant to ASH's domain, documenting prophylaxis failure due to resistance and raising concern about relying solely on ciprofloxacin for Aeromonas coverage during hirudotherapy. The limitation is that this is a single case report with no broader epidemiological or resistance surveillance data.

Citation

Ciprofloxacin-resistant Aeromonas hydrophila infection following leech therapy: a case report and review of the literature.

Patel KM et al. · Journal of plastic, reconstructive & aesthetic surgery, 2012

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.