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Our human war against infectious microbes has escalated. As bioscience has produced a stream of anti-bacterial and anti-fungal treatments, the continuously-evolving micro-organisms they target evolve in ways to protect themselves… and so our antibiotics become less effective.

This antibiotic resistance is estimated to result in more than 2.8 million infections from antibiotic-resistant bacteria, and more than 35,000 people die as a result. Antibiotic resistance adds $20 billion in excess direct healthcare costs each year in the US. Additional costs to society for lost productivity could be as high as $35 billion a year. All of this is driven in some measure by over-prescription (the CDC reckons that over 25% of antibiotics prescribed in US outpatient settings are unnecessary)– but the evolutionary dynamics of our microbial “enemies” being what they are, the problem would be material in any case.

So effective non-antibiotic treatments are especially valuable. Ian Ingram reports on one of the latest..

The FDA cleared medical-grade Australian sheep blowfly (Lucilia cuprina) larvae in what maker Cuprina Holdings believes marks the first debridement product to use this particular species.

Dubbed Medifly Maggots, the product [pictured above] is indicated for removing dead or infected tissue from non-healing necrotic skin and soft tissue wounds — such as pressure or neuropathic foot ulcers — and non-healing traumatic or post-surgical wounds.

A healthcare worker is required to oversee the application of the prescription maggot product, which was cleared based on demonstration of equivalence to the previously cleared medical-grade green bottle blowfly larvae — Lucilia sericata (Medical Maggots).

“Maggot debridement therapy has earned its place in modern wound care, and adding a second FDA-cleared species strengthens the entire field,” Ronald Sherman, MD, the company’s medical and scientific director, said in a statement.

“Lucilia cuprina has a meaningful international track record,” and the new clearance “gives clinicians and their patients more flexibility in how this therapy is delivered,” added Sherman, who has worked on the development of medical-grade maggots for decades and was instrumental in getting the first product cleared by the FDA in 2004.

According to recent estimates, anywhere from 1-2% of people in developed countries have chronic wounds, which are associated with greater risks of limb amputation and mortality.

Maggots, long used for clearing dead or non-healing tissue before the invention of antibiotics, can spare antibiotics and have also been associated with a lower risk of lower-limb amputation in diabetics with non-healing lesions…

As poet A. R. Ammons wrote (in “Catalyst“): “Honor the maggot, supreme catalyst.”

“New Type of Maggot Cleared by FDA as Medical Treatment,” from @medpagetoday.com.

* Christopher Moore

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As we rethink remedies, we might spare a thought for Alice Stewart; she died on this date in 2002. A physician and epidemiologist, she specialized in social medicine and the effects of radiation on health. Starting in WW II, she investigated the health effects of exposure to TNT in ammunitions factories, of carbon tetrachloride, and a prevalence of tuberculosis among shoe industry workers.

In the 1950s, Stewart led a pioneering study of x-rays (especially the pre-natal x-rays of expectant mothers) as a cause of childhood cancer. Her results were initially regarded as unsound, but were eventually accepted worldwide; the use of medical x-rays during pregnancy and early childhood was curtailed as a result– though it took around two and a half decades.

And after a visit to the U.S. in 1974, Stewart consulted on a major investigation of the health of workers in the nuclear industry there: she examined the sickness records of employees in the Hanford (WA) plutonium production plant and found a far higher incidence of radiation-induced ill health than was noted in official studies (produced by the nuclear industry).

Stewart was awarded the Right Livelihood Award in 1986 “for bringing to light in the face of official opposition the real dangers of low-level radiation.”  In 1997 she was invited to become the first Chair of the European Committee on Radiation Risk.

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