Implementation of a Leeches + Antimicrobial Prophylaxis Order Panel to Optimize Medicinal Leech Use at a Tertiary...

Area of Science:

• Biomedical Engineering
• Infectious Diseases
• Pharmacology

Background:

• Medicinal leech therapy is effective for vascular flow promotion and graft salvage.
• Leeches harbor symbiotic bacteria (Aeromonas species), posing a risk of infection transmission.
• Poor adherence to antimicrobial prophylaxis guidelines was observed in patients undergoing leech therapy.

Purpose of the Study:

• To assess the impact of an electronic medical record (EMR) order panel on antimicrobial prophylaxis adherence for medicinal leech therapy.
• To evaluate the effect of the EMR intervention on antibiotic ordering and timing.

Main Methods:

• Implementation of an EMR order panel for antimicrobial prophylaxis during medicinal leech therapy.
• Retrospective review of patient data before and after the EMR intervention.
• Analysis of antibiotic ordering patterns, timing of initiation, and incidence of Aeromonas infections.

Main Results:

• The EMR order panel led to improved adherence with antimicrobial prophylaxis recommendations.
• Significant increases in antibiotic ordering and appropriate timing of prophylaxis initiation were observed post-implementation.
• Aeromonas infections remained rare, occurring primarily in patients with non-optimized prophylaxis.

Conclusions:

• EMR order panels are effective in improving adherence to antimicrobial prophylaxis for medicinal leech therapy.
• Optimized prophylaxis is crucial for preventing Aeromonas infections in patients undergoing leech therapy.
• This intervention enhances patient safety during medicinal leech therapy.