■从业者和科学家正在重新研究边缘化的伤口护理疗法,以找到在不影响患者预后的情况下应对日益增长的抗菌素耐药性(AMR)问题的策略。Maggot疗法(MT)仅占英国国家卫生服务在伤口护理方面支出的0.02%。这项研究旨在揭示为什么MT不经常使用,尽管它的负担能力和高水平的清创和消毒功效,特别是在AMR感染的情况下,并确定可以采取哪些措施来确保将来更有效地使用MT来改善患者预后并管理日益严重的AMR问题。
■对于这项调查,我们采用系统评价和Meta分析的首选报告项目框架,对使用MT抗AMR感染的病例研究进行了定性评价,并对随机对照试验(RCT)进行了定量分析.
■分析表明,MT对一系列感染和伤口类型非常有效,与传统疗法相比,效果很好。MT使用率低的部分原因可能是由于记录的“恶心因素”,通常与got以及对成本的误解有关,MT的功效和可及性。为了克服这些因素,需要更多关于MT在各种临床表现中的频谱和疗效的随机对照试验,以及专业和公众参与活动。
■MT是一种未充分利用的疗法,特别是关于AMR感染,在这种情况下扩大其使用似乎是有道理的。MT可以在保护现有抗菌药物库的功效方面发挥至关重要的作用,应在制定抗菌药物管理计划时予以考虑。
■这项工作得到了斯旺西就业学院的支持,斯旺西大学(内部资助)。作者没有利益冲突要声明。
UNASSIGNED: Practitioners and scientists are re-examining marginalised wound care therapies to find strategies that combat the growing problem of antimicrobial resistance (AMR) without compromising patient outcomes. Maggot therapy (MT) makes up just an estimated 0.02% of UK\'s National Health Service spending on wound care. This study aims to uncover why MT is not used more often, despite its affordability and high level of efficacy for both debridement and disinfection, particularly in the context of AMR infections, and to determine what can be done to ensure MT is more effectively used in the future to improve patient outcomes and manage the growing problem of AMR.
UNASSIGNED: For this investigation, a qualitative review of case studies using MT against AMR infections and a quantitative analysis of randomised control trials (RCTs) were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework.
UNASSIGNED: Analysis showed that MT is highly effective against a range of infections and wound types, and compares well against conventional therapies. The low use of MT may be due in part to the documented \'yuck factor\', often associated with maggots as well as misconceptions around the cost, efficacy and accessibility of MT. To overcome these factors, more RCTs on the spectrum and efficacy of MT across various clinical manifestations are needed, as well as professional and public engagement campaigns.
UNASSIGNED: MT is an underused therapy, particularly regarding AMR infections, and expanding its use in these circumstances appears warranted. MT could play a vital role in conserving the efficacy of the existing pool of antimicrobials available and should be considered in the development of antimicrobial stewardship programmes.
UNASSIGNED: This work was supported by the Swansea Employability Academy, Swansea University (internal funding). The authors have no conflicts of interest to declare.