Implementation of a Leeches + Antimicrobial Prophylaxis Order Panel to Optimize Medicinal Leech Use at a Tertiary Care Academic Medical Center
Quality improvement study published in Journal of Pharmacy Practice (2021)
Abstract
Medicinal leech therapy promotes vascular flow and can be used to salvage grafts. Medicinal leeches have a symbiotic relationship with Aeromonas species and can therefore present a risk of bacterial transmission to patients. Antimicrobial prophylaxis is warranted for the duration of leech therapy, however, an institutional evaluation of 40 patients receiving medicinal leech therapy demonstrated poor adherence with recommendations. An electronic medical record order panel for antimicrobial prophylaxis with medicinal leech therapy was implemented, leading to a subsequent improvement in adherence to prophylaxis use, including significant increases in the ordering of antibiotics and the appropriate timing of initiation in the subsequent 10 patients receiving medicinal leech therapy after panel implementation. Aeromonas infections were rare before and after panel implementation, and developed only in the patient subset with non-optimized prophylaxis.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Implementation of an electronic medical record order panel for antimicrobial prophylaxis with medicinal leech therapy significantly improved adherence to ordering and timing; Aeromonas infections occurred only with non-optimized prophylaxis.
Why This Matters for Hirudotherapy
This study describes the implementation of an electronic medical record order panel linking medicinal leech therapy with antimicrobial prophylaxis. An initial institutional evaluation of 40 patients receiving leech therapy demonstrated poor adherence to prophylaxis recommendations. Following panel implementation, the subsequent 10 patients showed significant increases in both antibiotic ordering and appropriate timing of prophylaxis initiation. Aeromonas infections were rare before and after implementation and occurred only in the patient subset with non-optimized prophylaxis. These findings are relevant to hirudotherapy quality improvement, suggesting that standardized order sets can enhance adherence to infection prevention practices. However, Aeromonas infections were rare throughout, limiting the data available to assess the panel's impact on infection rates specifically.
Citation
Reference (Vancouver style)
Palm NM, Wesolowski JC, Wu JY, Srinivas P. Implementation of a Leeches + Antimicrobial Prophylaxis Order Panel to Optimize Medicinal Leech Use at a Tertiary Care Academic Medical Center. J Pharm Pract. 2022;35(3):427-430. doi:10.1177/0897190021993683. PMID: 33563061
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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