Preventing infective complications following leech therapy: is practice keeping pace with current research?
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.
Whitaker
Iain S
IS
Department of Molecular and Cell Biology, University of Connecticut, CT, USA. iainwhitaker@fastmail.fm
Kamya
Cyril
C
Azzopardi
Ernest A
EA
Graf
Joerg
J
Kon
Moshe
M
Lineaweaver
William C
WC
D000333:Aeromonas; D000818:Animals; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D016905:Gram-Negative Bacterial Infections / Q000517:prevention & control*; D006801:Humans; D007494:Ireland; D007865:Leeches / Q000382:microbiology; D024763:Leeching / Q000009:adverse effects*; D019651:Plastic Surgery Procedures; D006113:United Kingdom