From the Guidelines
For a leech bite on the leg, the most effective treatment involves removing the leech by applying salt, alcohol, or heat near it to make it detach naturally, then washing the area thoroughly with soap and water, as recommended for human and animal bites 1.
Initial Treatment
- Remove the leech by applying salt, alcohol, or heat near it to make it detach naturally—never pull it off forcefully as this may leave mouthparts embedded in the skin.
- Once removed, wash the area thoroughly with soap and water, following the guidelines for wounds and abrasions which suggest thorough irrigation with a large volume of warm or room temperature potable water with or without soap until there is no foreign matter in the wound 1.
Wound Care
- Apply gentle pressure with a clean cloth if bleeding continues, as leeches release hirudin, an anticoagulant that prevents blood clotting.
- Apply an antiseptic like povidone-iodine or hydrogen peroxide to prevent infection, considering the recommendation for covering wounds with an antibiotic ointment or cream and a clean occlusive dressing to promote healing and reduce infection 1.
Pain Management and Monitoring
- Cover the wound with a clean bandage and change it daily until healed.
- Take acetaminophen (500-1000mg every 6 hours as needed) for pain.
- Watch for signs of infection such as increasing redness, warmth, swelling, or pus, which would require medical attention.
- Also, seek medical help if you develop fever, rash, or unusual symptoms within weeks after the bite, as rarely, leeches can transmit infections.
Outcome
Most leech bites heal completely within a week without complications, emphasizing the importance of proper initial treatment and wound care to prevent infection and promote healing, in line with the guidelines for managing wounds and abrasions 1.
From the Research
Leech Bite Treatment
- The treatment of leech bites involves managing bleeding and preventing infection 2, 3.
- Leeches have been used as a medicinal remedy for years, and their salivary contents contain pharmacologically active compounds that can cause bleeding 2.
- Prolonged bleeding is a possible complication of leech bites, and treatment principles include managing the wound and preventing infection 3.
Infection Prevention
- Infections can occur after leech therapy, and Aeromonas spp. are a common cause of infection 4, 5, 6.
- Prophylactic antibiotic administration is recommended before and during leech therapy to prevent infections 5, 6.
- Ciprofloxacin and trimethoprim-sulfamethoxazole appear to be equally effective at preventing leech-associated infections 6.
Antibiotic Resistance
- The use of antibiotics in leech therapy can select for resistant pathogens, including Aeromonas spp. 4.
- Subtherapeutic concentrations of antibiotics can provide a competitive advantage for resistant strains, leading to an increase in antibiotic-resistant infections 4.
- The eradication of symbiotic Aeromonas spp. from the intestine of Hirudo verbana using antibiotic feeding can reduce the risk of infection 5.