Maggots to the rescue as antibiotic resistance rises

Posted on the 7th February 2023

A centuries-old tradition practised by Maya tribes in Central America and Indigenous Australians could be the secret weapon in combatting increasing cases of antibiotic resistance.

‘Maggot therapy’ has been available as a prescribed NHS treatment since 2004 and, in America, the Food and Drug Administration (FDA) approved their use, having classified maggots as a medical device.

The creepy crawlies have already proven invaluable in speeding up the healing process, but they are now proving equally worthy in their ability to overcome antibiotic resistance caused by the overuse of medicines.

While not a new treatment, the use of maggots dwindled as the popularity of penicillin and other antibiotics grew.

Amid a growing antibiotic resistance, maggots have enjoyed a revival over the last two decades and clinical-grade larvae are now reared in the US, Australia, China, UK, Turkey, and across Africa.

Greenbottle fly larvae are grown in the lab, disinfected, and put into finely woven net pouches about the size of a teabag that are then placed on patients’ wounds for four days.

The maggots work their magic through the material and the bags are removed before they turn into flies.

As larvae feed on dead tissue in a wound, they release chemicals that break down dead tissue into a liquid that they drink. They also take up bacteria, which are destroyed within their gut but do not eat healthy tissue.

When applied to the wound, the larvae are the size of an uncooked grain of rice and grow to around 10-12mm during treatment. They cannot bite, since they do not have teeth, and they cannot multiply.

Aside from improving patients’ quality of life, maggots are also very cost-effective, greatly reducing the reliance on nursing resources and the cost of surgical debridement (the medical removal of dead tissue). They can also eradicate the need for amputations.