Rethinking antimicrobial prophylaxis in patients receiving medicinal leech therapy
Case report published in American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists (2022)
Abstract
PURPOSE: To describe challenges in the management of prophylaxis against infections for patients receiving medicinal leech therapy given changes in antimicrobial resistance patterns in the normal flora of leeches. SUMMARY: This article presents a patient case of reconstructive surgery complicated by infection associated with the use of medicinal leeches, as well as a discussion of prophylaxis in medicinal leech therapy, focusing on considerations for choosing a prophylactic agent. CONCLUSION: Our case report highlights resistance changes in Aeromonas isolates associated with medicinal leeches and the potential for complications if isolates resistant to chosen prophylactic agents arise. When administering antimicrobial prophylaxis in patients receiving medicinal leech therapy, clinicians should be familiar with the susceptibilities of Aeromonas species but also conscious of evolving antimicrobial resistance given the extent of the consequences of infected surgical grafts.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
This case report and review describes a reconstructive surgery patient who developed an infection linked to medicinal leech use, highlighting evolving Aeromonas resistance to prophylactic agents and the need for clinicians to consider current susceptibility patterns.
Why This Matters for Hirudotherapy
This case report examines the clinical challenges of antimicrobial prophylaxis in patients receiving medicinal leech therapy, specifically detailing a reconstructive surgery case complicated by an infection associated with leech use. Because hirudotherapy relies on the application of live leeches, understanding the evolving antimicrobial resistance patterns in the normal flora of these leeches—particularly Aeromonas species—is critical for preventing severe surgical graft infections and ensuring patient safety. The report highlights the need for clinicians to stay informed about local resistance susceptibilities when choosing prophylactic agents. However, as the insights are derived from a single patient case report, the findings are limited in scope and lack broader quantitative outcome data, meaning the proposed prophylaxis strategies require further clinical validation.
Citation
Reference (Vancouver style)
McCracken JA, Koehler SM, Sharma R. Rethinking antimicrobial prophylaxis in patients receiving medicinal leech therapy. Am J Health Syst Pharm. 2022;79(1):e14-e19. doi:10.1093/ajhp/zxab330. PMID: 34390241
Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.
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