Prophylactic use of levofloxacin during medicinal leech therapy

Research article published in International journal of clinical pharmacy (2014)

Última actualización: June 18, 2026Revisado por: ASH Editorial Board

Research article — evidence reviewArticle reference

Evidence: Research reportSeguridad y control de infeccionesEnsayos clínicosBauters T et al. · International journal of clinical pharmacy, 2014

Abstract

BACKGROUND: Medicinal leech therapy is effective in establishing venous outflow in congested flaps and replants. However, its use is also associated with infections, especially from Aeromonas species. To prevent this nosocomial infection, levofloxacin has been established as prophylaxis during leech therapy in our hospital. OBJECTIVES: To study the implementation rate of a guideline, to study the effect of levofloxacin on possible Aeromonas infections, and to evaluate the financial impact of this preventive measure. SETTING: A retrospective analysis on all patients treated with Hirudo medicinalis between July 2007 and March 2011 was performed at the Ghent University Hospital, Belgium. METHOD: A list of patients treated with leeches was retrieved from the pharmacy database. Patient characteristics, date of start and stop of leech therapy were collected. Data on routine diagnostic cultures during leech therapy, date and type of clinical sample, while cultivated micro-organism with antibiotic susceptibility were obtained from the laboratory database. MAIN OUTCOME MEASURE: percentage implementation rate of a guideline, presence of Aeromonas infections, financial impact of levofloxacin prophylaxis. RESULTS: Fifty-one patients were treated with leeches. Forty-six (90.2 %) patients were treated according the guideline. Fourteen out of 51 patients (27.5 %) were suspected for postoperative wound infections. From them, 60 clinical samples were sent for microbiological analysis. These included exudates (26.7 %), peroperative samples (5.0 %), puncture fluid (1.7 %), blood cultures (3.3 %) or smears from burns (63.3 %). No Aeromonas species were cultivated. Comparison between period before and after implementation of levofloxacin prophylaxis revealed that levofloxacin prevents colonization or infection with Aeromonas species in relation to leech therapy. The direct cost for levofloxacin prophylaxis in the current study was 2,570 euro. Based on data obtained in a previous study, we presume that a minimum cost-saving of 20,500 euro was realised during the current study period by implementation of antimicrobial prophylaxis. CONCLUSIONS: This study demonstrates successful implementation of a guideline for levofloxacin prophylaxis during leech therapy. Following its introduction, no Aeromonas species related to the use of leeches were isolated as compared to 8.5 % in the baseline period.

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

Publication typeJournal Article

Indexed MeSH termsAdolescentAdultAeromonasAnti-Bacterial AgentsAntibiotic ProphylaxisChildCost-Benefit AnalysisFemaleGram-Negative Bacterial InfectionsGuideline AdherenceHumansLeeching

Resumen

Medicinal leech therapy is effective in establishing venous outflow in congested flaps and replants. However, its use is also associated with infections, especially from Aeromonas species.

Por qué esto importa para la hirudoterapia

Este estudio reportó un análisis retrospectivo de 51 pacientes tratados con sanguijuelas medicinales (Hirudo medicinalis) en el Hospital Universitario de Gante, Bélgica, evaluando la tasa de implementación, los desenlaces microbiológicos y el impacto financiero de la profilaxis con levofloxacino contra la infección por Aeromonas. Esto es directamente relevante para la práctica clínica de la hirudoterapia, ya que la colonización por Aeromonas es una complicación reconocida de la terapia con sanguijuelas, y los hallazgos aportan datos institucionales que respaldan la profilaxis antibiótica como estrategia de mitigación de riesgos durante el uso de sanguijuelas. Sin embargo, este fue un análisis retrospectivo unicéntrico con un tamaño de muestra modesto, y la estimación de ahorro de costos fue extrapolada de un estudio previo en lugar de medirse directamente. Los resultados reflejan la experiencia local con una guía de profilaxis específica, y la generalizabilidad a otras instituciones, poblaciones de pacientes o regímenes antibióticos es incierta.

Citación

Prophylactic use of levofloxacin during medicinal leech therapy.

Bauters T et al. · International journal of clinical pharmacy, 2014

DOI

Contexto clínico relacionado

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Aviso legal — investigación y educación

La información en esta página se proporciona únicamente con fines educativos e informativos y no constituye asesoramiento médico, diagnóstico o recomendaciones de tratamiento. Los resúmenes de evidencia clínica reflejan la literatura publicada revisada por pares y no implican eficacia terapéutica fuera de los contextos autorizados por la FDA.

La autorización FDA 510(k) para sanguijuelas medicinales se limita a indicaciones específicas. Las aplicaciones en investigación y fuera de indicación se identifican como tales. Los profesionales deben consultar las directrices vigentes de la FDA, los protocolos institucionales y las normativas estatales aplicables antes del uso clínico.

ASH apoya la evaluación rigurosa basada en evidencia de todas las aplicaciones de hirudoterapia mediante ensayos clínicos controlados e investigación revisada por pares.

Añadido a la biblioteca ASH: March 18, 2026 · Última actualización del sitio: June 18, 2026