BACKGROUND: Maggots' ability to prevent infections and promote wound healing has been known since the 19th century. Increasing problems with treatment-resistant wounds and antibiotic-resistant bacteria has aroused interest in maggot therapy. MATERIAL AND METHODS: Literature on maggot therapy - identified through a non-systematic search of Pubmed - was reviewed. RESULTS: Maggot therapy is the medical use of disinfected fly larvae (usually the larvae of Lucilia sericata) in treatment of wounds resistant to conventional treatment. The maggots work through three mechanisms of action; they debride wounds by dissolving necrotic tissue, clean wounds by killing bacteria and promote wound healing. The larvae have a broad antibacterial action against Gram-negative and Gram-positive bacteria, including MRSA. Maggot therapy is used to debride a number of complicated skin and soft tissue wounds - e.g.. pressure ulcers, venous stasis ulcers, neurovascular ulcers, traumatic wounds and burns - but also as a treatment for osteomyelitis. Large controlled clinical trials have not been performed. Maggot therapy has not been associated with serious side effects. INTERPRETATION: Maggot therapy seems to be an effective and environmentally friendly treatment of complicated necrotic wounds that are resistant to conventional treatment. Maggot therapy should also be considered in earlier stages of treatment.

Photodynamic therapy has been investigated as an alternative method of killing pathogens in response to the multiantibiotic resistance problem. This study evaluated the photodynamic effect of curcumin on methicillin-resistant Staphylococcus aureus (MRSA) compared to susceptible S. aureus (MSSA) and L929 fibroblasts. Suspensions of MSSA and MRSA were treated with different concentrations of curcumin and exposed to light-emitting diode (LED). Serial dilutions were obtained from each sample, and colony counts were quantified. For fibroblasts, the cell viability subsequent to the curcumin-mediated photodynamic therapy was evaluated using the MTT assay and morphological changes were assessed by SEM analysis. Curcumin concentrations ranging from 5.0 to 20.0 μM in combination with any tested LED fluences resulted in photokilling of MSSA. However, only the 20.0 μM concentration in combination with highest fluence resulted in photokilling of MRSA. This combination also promoted an 80% reduction in fibroblast cell metabolism and morphological changeswere present, indicating that cell membrane was the main target of this phototherapy. The combination of curcumin with LED light caused photokilling of both S. aureus strains and may represent an alternative treatment for eradicating MRSA, responsible for significantly higher morbidity and mortalityand increased healthcare costs in institutions and hospitals.

Nepeta cataria L., commonly known as catnip, is a perennial herb with a considerable folkloric reputation. A diethyl ether extract of this plant has been shown to have antimicrobial activity against fungi and Gram-positive bacteria. The aim of this work was to study the activity of N. cataria extract on 44 Staphylococcus aureus strains, some resistant to methicillin, and S. aureus 6538P (American Type Culture Collection) by evaluating the effect of subminimum inhibitory concentrations on coagulase, DNAse, thermonuclease and lipase production, and on in-vitro adherence. DNAse, thermonuclease and lipase were inhibited by concentrations equal to 1/2 and 1/4 MIC. A reduction of adherence was also observed.