Abstract
Background Medicinal leeches (Hirudo medicinalis) are indicated for salvage of tissue flaps, grafts, or replants when venous congestion
threatens tissue viability. The purpose of this study was to evaluate the efficacy
of prophylactic antimicrobial agents in patients who received medicinal leech therapy.
Materials and Methods A multicenter retrospective cohort study of all adult patients between January 1,
2010, and February 28, 2013, who received medicinal leech therapy was conducted.
Results Antimicrobial prophylaxis was documented in 54 (91.5%) of the included patients,
ciprofloxacin, trimethoprim-sulfamethoxazole, piperacillin-tazobactam, and ceftriaxone
in 33 (61.1%), 18 (33.3%), 2 (3.7%), and 2 (3.7%) patients, respectively. Surgical
site infection (SSI) was found in seven (11.9%) patients, all of whom received antimicrobial
prophylaxis. Aeromonas spp. was isolated in four infections, and all isolates were resistant to the chosen
prophylactic agent. The SSI incidence was similar between antimicrobial prophylaxis
agents.
Conclusion Trimethoprim-sulfamethoxazole and ciprofloxacin appear equally effective at preventing
leech-associated infections.
Keywords
leech - antimicrobial prophylaxis - surgical site infection
