Beyond Antibiotics: Harnessing Bacteriotherapy to Heal Chronic Lymphatic Filariasis Wounds

The rising incidence of antibiotic-resistant bacteria such as multidrug-resistant Staphylococcus aureus (MRSA), drug-resistant E. coli, and Pseudomonas aeruginosa in chronic filarial wounds critically undermines the efficacy of antibiotics as standard therapies for chronic wounds in lymphatic filariasis. This challenge is intensified by widespread antibiotic misuse and self-medication among patients, complicating infection control and prolonging wound healing. As a result, there is a pressing need to adopt innovative treatment approaches. Bacteriotherapy represents a promising strategy for managing these chronic filarial wounds by effectively addressing persistent infections and inflammation that impede healing. This review comprehensively assesses current evidence to hypothesize the potential for advanced bacteriotherapeutic approaches in managing the complex morbidities of lymphatic filariasis, including lymphedema and its recurrent, complicated wounds. The findings highlight the potential of these innovative strategies to improve patient outcomes by targeting both filarial parasites and secondary bacterial infections. However, translating this promise into clinical practice requires further rigorous research, optimized treatment protocols, and tailored interventions suitable for endemic settings.