title: Preventing infective complications following leech therapy: is practice keeping pace with current research?
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.
authors.affiliation: Department of Molecular and Cell Biology, University of Connecticut, CT, USA. iainwhitaker@fastmail.fm
authors.forename: Iain S
authors.initials: IS
authors.lastname: Whitaker
authors.forename: Cyril
authors.initials: C
authors.lastname: Kamya
authors.forename: Ernest A
authors.initials: EA
authors.lastname: Azzopardi
authors.forename: Joerg
authors.initials: J
authors.lastname: Graf
authors.forename: Moshe
authors.initials: M
authors.lastname: Kon
authors.forename: William C
authors.initials: WC
authors.lastname: Lineaweaver
mesh_terms: 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