The use of medicinal leeches (Hirudo medicinalis) is effective in establishing venous outflow in congested flaps and replants.1,2 Leech therapy also has associated risks, including significant blood loss requiring transfusions and infections from Aeromonas, a gram-negative bacilli.2 Leeches maintain a symbiotic relationship with Aeromonas species, which are resident to their gut in order to digest blood. Aeromonas hydrophila infections can result in extensive soft-tissue infections and myonecrosis.3 To prevent this devastating nosocomial infection, ciprofloxacin and/or trimethoprim-sulfamethoxazole (TMP-SMX) are the most commonly used prophylactic antibiotics when patients undergo leech therapy.1,4
Wang EW, Warren DK, Ferris VM, Casabar E, Nussenbaum B. Leech-Transmitted Ciprofloxacin-Resistant Aeromonas hydrophila. Arch Otolaryngol Head Neck Surg. 2011;137(2):190–193. doi:10.1001/archoto.2010.257
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