Maggots Are Back (Again)

Novelist Isak Dinesen described maggots as an abundance of horror, but for diabetics with drug-resistant infections in their feet, maggots are healers, despite being repulsively slimy and slithery. It has been known since at least the American Civil War, and probably long before then, that throwing a handful of certain species of these creepy crawlers on wounds can gobble away infection.

Yum!

A quarter of all diabetics are at risk of contracting foot ulcers because of reduced blood circulation, and increasingly, these wounds are becoming infected with antibiotic-resistant bacteria such as Staphylococcus aureus (MRSA). The failure of modern drugs has led a team at Manchester University, in the United Kingdom, to propose an increased use of “larval therapy,” a less gross term for maggot treatments. Maggots have been used here and there for a decade, according to an article in News@Nature, but what’s new is that Andrew Boulton, the team leader, has received a grant to compare the maggot treatment with modern remedies.

This is yet another instance in which modern medicine and science should pay more attention to old-fashioned therapies that have been proven to work. Just because they do not involve complex synthetic molecules designed by teams of innovative scientists, and they don’t cost millions of dollars to develop, doesn’t mean we should avoid “horrors” of nature such as maggots.

Initially, in a small trial, Boulton’s team found that the maggots healed the wounds of 12 out of 13 patients who received between three and five applications, each lasting four to five days. Then, curiously, the United Kingdom’s Medicines and Healthcare Products Regulatory Agency shut down Boulton and his team, claiming that the maggot-healing technique is a new therapy that requires a special license. Go figure.

Boulton expects to have his license in a few weeks. Meanwhile, he is working with microbiologists to try to figure out why and how the maggots do what they do. News@Nature reports,

The maggots might secrete an antibacterial goo, or they might be just devouring the infected flesh. Boulton has noticed that the MRSA infection is highly concentrated around the maggots–rather like iron filings around a magnet, he says. But at the moment how and why this happens is a mystery.

Initial study of the 12 out of 13 patients helped by maggots: Bowling F. L., Salgami E. V., Boulton A. J. M., et al. Diabetes Care, 30. 370-371 (2007).