The Effect of Antibiotics on Lucilia sericata s Maggot in the Treatment of Patients with Osteomyelitis

Research Article

J Bacteriol Mycol. 2021; 8(3): 1171.

The Effect of Antibiotics on Lucilia sericata’s Maggot in the Treatment of Patients with Osteomyelitis

Polat E¹, Matlabi N²* and Kutlubay Z³

1Department of Medical Microbiology/Traditional, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, and Complementary Medicine Application and Research Center, Turkey

2Department of Medical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Turkey

3Department of Dermatology and Venereal Diseases/ Traditional, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Turkey

*Corresponding author: Naser Matlabi, Department of Medical Microbiology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Turkey

Received: April 13, 2021; Accepted: May 08, 2021; Published: May 15, 2021


Objective: Applying antibiotics and maggot of Lucilia sericata, in our study, it was aimed to treat patients with osteomyelitis who had been treated with antibiotics, hyperbaric oxygen, vacuum, classical treatment methods and surgical debridement for a long time but did not show any improvement.

Methods: Between July 2008 and September 2018, Maggot Debridement Therapy (MDT) was planned for 257 patients with osteomyelitis, 74 women and 183 men. Before starting the treatment, the material was taken from the wounds of the patients and sent to the microbiology laboratory. The antibiotic treatment that was initiated in the patients was continued and L. sericata maggot were placed in their wounds twice a week, and they were removed from the wound after being held for 48-72 hours.

Results: From 165 patients with ongoing oteomyelitis treatment, 156 patients (94.5%) were treated, but 9 patients (5.5%) were untreated.

Keywords: Antibiotic; Lucilia sericata maggot; Maggot debridement therapy and osteomyelitis


Osteomyelitis, also known as bone inflammation, is caused by pyogenic bacteria inoculation, directly or through the blood circulation into the bone. Many bacteria, especially Staphylococcus aureus, can cause osteomyelitis. These bacteria can be transmitted through fractures, penetrating injuries, or surgical procedures. Osteomyelitis, which can be seen in almost all age groups, was common in the past but has recently decreased due to antibiotic use [1]. If osteomyelitis is not treated due to clinical, economic and social conditions, the patient is given an amputation of the organ. Failure in amputation site’s improvement poses another problem for the patient. Today, in the treatment of osteomyelitis; conventional methods such as antibiotic therapy, hyperbaric oxygen therapy, vacuum therapy, surgical debridement, drainage and removal of foreign bodies are used [2-4]. In the treatment of osteomyelitis caused by bacteria, L. sericata type fly maggot, which have bacteriositatic and bactericidal effects on bacteria, can also be used. The maggot of this fly species feed only on dead tissues and do not cause any damage to healthy tissues [5]. The maggot dissolve necrotic tissues with the enzymes they secrete, eat the microorganisms in the wound and disinfect the wound by showing bacteriostatic and bactericidal effects on these microorganisms. At the same time, maggot, which initiate tissue granulation and activate growth factors, provide rapid improvement of wounds [6-7]. Because of these features, MDT has been used in the treatment of injured organs that have been hardly healed or faced non-healing amputation decisions since 2007. Due to the successful results, amputations caused by wounds were prevented. The completely natural treatment method has no side effects on personnel or the environment. In this study, the treatment of 257 cases of osteomyelitis diagnosed with antibiotics, surgical curettage and drainage, removal of foreign bodies, vacuum and hyperbaric oxygen treatments were decided to be amputated with L. sericata maggot and antibiotics.

Patients and Methods

Between 01.01.2008-31.12.2018, a 4-year-old girl with osteomyelitis, 73 (28.4%) female and 183 (71.6%) male, applied to our unit. The patients were informed about the maggot treatment, the consent forms were filled in and signed by the patient who accepted the treatment. In 2006, the treatment of maggot, which was approved by ethics committee article 14620, is planned to be implemented. The wounds of the patients were cleaned with sterile saline; the photographs were taken, the material was taken to determine the bacteriological culture and antibiotic sensitivity and were sent to the medical microbiology laboratory (Figure 1A). Depending on the size and depth of the wound, stage I or II, larvae were placed on the wound and covered with a sterile sponge. Patients were advised to change the dressing frequently to keep the wound humid. Maggots were thrown into the garbage after being kept on the wound for 48-72 hours. This process was done twice a week. Maggot treatment was applied twice a week until the necrotic tissue in the wound was completely cleaned, bacteria did not grow in the materials taken and the bad smell from the wound disappeared. It was administered once a week, once every two weeks, or once a month in the progressive treatment process. If the wound did not improve during the controls, treatment of the maggot was continued [8-9].