American Society of Hirudotherapy

Infection risk related to the use of medicinal leeches

Research article published in Pharmacy world & science : PWS (2007)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Preclinical (animal)Safety & Infection ControlBauters et al. · Pharmacy world & science : PWS, 2007

Abstract

OBJECTIVE: To assess the incidence of postoperative wound infections related to treatment with medicinal leeches at Ghent University Hospital. METHOD: A 2-year retrospective analysis of bacteriologic culture results of soft tissue infections in patients treated with medicinal leeches. RESULTS: Cultures of suspected wound infections were taken and susceptibility testing of isolates was performed on 17 of 47 patients (36.2%). Aeromonas was frequently isolated (18.5%). CONCLUSIONS: A high incidence of infection during and after application of medicinal leeches, despite their external decontamination, necessitates an antibiotic prophylaxis. In particular Aeromonas must be covered, as soft tissue infections with these bacteria can give serious complications. The prophylactic antibiotic should cover the most frequent isolated species taking into account the importance of Aeromonas and the susceptibility pattern. Based on the results, fluoroquinolones seem to be a good choice. The authors believe that practical recommendations to hospital pharmacists on prophylaxis during Hirudo medicinalis treatment, might enhance the safety of it's use by reducing the number of infections.

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

Publication typeJournal Article
Indexed MeSH termsAdolescentAdultAeromonasAgedAged, 80 and overAnimalsAnti-Bacterial AgentsBacterial InfectionsBelgiumChildChild, PreschoolChlorhexidine

Summary

Peer-reviewed research on safety and infection-control considerations relevant to leech therapy and anticoagulation. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This 2-year retrospective analysis at Ghent University Hospital directly examined postoperative wound infections in patients treated with medicinal leeches (Hirudo medicinalis), culturing suspected infections in 17 of 47 patients and frequently isolating Aeromonas (18.5%), and concluded that the infection incidence despite external decontamination necessitates antibiotic prophylaxis, with fluoroquinolones suggested as a reasonable choice given the Aeromonas susceptibility pattern. This is squarely relevant, core safety literature for hirudotherapy: Aeromonas, a normal gut commensal of the leech, is the central infectious risk of leech therapy, and this study supports the standard practice of prophylactic antibiotic cover during Hirudo medicinalis treatment. The honest caveat is that this is a single-center retrospective study from 2007 with a modest sample and culture only in a subset of patients; the specific antibiotic recommendation reflects that center's local susceptibility data and should be confirmed against current local resistance patterns rather than treated as a fixed protocol.

Citation

Infection risk related to the use of medicinal leeches.

Bauters et al. · Pharmacy world & science : PWS, 2007

Added to ASH library: May 28, 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.