Preventing infective complications following leech therapy: is practice keeping pace with current research?
Survey study published in Microsurgery (2009)
Abstract
BACKGROUND: Despite several publications strongly advocating prophylactic antibiotics during leech therapy, and recent primary articles shedding new light on the microbiota of leeches, many units either do not use antibiotic prophylaxis, or are continuing to use ineffective agents. METHODS: A 5-year follow-up of plastic surgery units in the United Kingdom and the Republic of Ireland was conducted in 2007 to ascertain current practice regarding the use of prophylactic antibiotics with leech therapy. A comprehensive literature search investigated primary research articles regarding the microbiota of leeches to update the reconstructive surgery community. RESULTS: Despite published evidence to support the use of prophylactic antibiotics during leech therapy, 24% of units do not use antibiotic prophylaxis and 57% of those using antibiotics are using potentially ineffective agents. Advanced molecular genetic techniques, which allow accurate characterization of both culturable and non-culturable microbiota of the leech digestive tract, show a wider diversity than at first thought, with variable antibiotic resistance profiles. CONCLUSIONS: Despite infection due to leech therapy being a well known and relatively common complication, many units are not using appropriate antibiotic prophylaxis.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
5-year follow-up of UK/Ireland plastic surgery units shows 24% do not use antibiotic prophylaxis and 57% of those using antibiotics use potentially ineffective agents, despite published evidence supporting prophylaxis.
Why This Matters for Hirudotherapy
This study reports a five-year follow-up conducted in 2007 of plastic surgery units in the United Kingdom and the Republic of Ireland regarding prophylactic antibiotic use during leech therapy, combined with a literature search on the microbiota of leeches. The survey found that 24% of units do not use antibiotic prophylaxis and 57% of those using antibiotics are using potentially ineffective agents. The literature search, noting that advanced molecular genetic techniques reveal greater microbial diversity in the leech digestive tract than previously appreciated, found variable antibiotic resistance profiles. The authors conclude that many units are not using appropriate antibiotic prophylaxis despite well-known infection risks associated with leech therapy. These findings are relevant to hirudotherapy practice, documenting the gap between published evidence on prophylaxis and actual clinical practice in these regions.
Citation
Preventing infective complications following leech therapy: is practice keeping pace with current research?
Whitaker IS, Kamya C, Azzopardi EA, Graf J, Kon M, Lineaweaver WC · Microsurgery, 2009
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