Doctors have started enacting the maggot again

If antibiotics won't clear a surface infection, you now have an alternative - maggots

If antibiotics won't clear a surface infection, you now have an alternative - maggots. Clinical trials have shown that the larvae of the common greenbottle fly, lucilia sericata, can help clear up infected wounds and promote healing.

Dr Steve Thomas and colleagues from the Princess of Wales Hospital, Bridgend, Wales, extol the virtues of fly larvae in a report in the current issue of the British Medical Journal. They believe that maggots might hold promise in healing wounds involving antibiotic-resistant bacteria strains.

The technique is nothing new and was described in the medical press some decades ago, but it has been reintroduced in various UK hospitals, the authors note. They describe how 3,500 containers of sterile maggots have been supplied to 40 medical centres.

The technique, being described in some quarters as "biosurgery", involves applying the larvae to the wound and allowing them to begin digesting material found there. Particularly good results have been reported, they said, in the treatment of deep infected ulcers which are a common feature of diabetes.

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Researchers are unsure as yet how the maggots help, whether they produce natural antibiotic agents, change the acidity of the wound or simply gobble up and destroy the invading bacteria as part of their normal feeding process. There are some results which suggest that they produce growth-promoting agents which speed healing.

Many patients receive larval treatment as a last resort, but the authors argue that the earlier application of maggots should be considered "which in many cases would obviate the need for topical or systemic anti-microbial treatment".