Pushing the frontiers in the fight against antimicrobial resistance: the potential of fecal and maggot therapies

Abstract

The escalating crisis of antimicrobial resistance (AMR) warrants innovative therapeutic strategies. Fecal microbiota transplantation (FMT) and maggot debridement therapy (MDT) represent paradigm-shifting approaches, leveraging biological systems to mitigate AMR. FMT restores a healthy gut microbiome, providing a biotherapeutic counter to pathogenic bacteria, thereby reducing reliance on traditional antibiotics. Conversely, MDT, a form of bio-debridement, utilizes the antimicrobial secretions of maggots to cleanse wounds and eliminate resistant bacteria. Despite the promise these therapies hold, their broader clinical adoption faces multifaceted challenges including the need for rigorous scientific substantiation, standardized protocols, deepened understanding of mechanisms of action, and surmounting regulatory and public acceptance barriers. However, their potential integration with precision medicine could revolutionize disease management, particularly with antibiotic-resistant infections. Plain language summary The rising problem of drug-resistant infections calls for new treatment methods. Fecal microbiota transplantation (FMT) and maggot debridement therapy (MDT) offer innovative solutions. FMT uses healthy gut bacteria to fight harmful ones, while MDT employs maggots to clean wounds and kill resistant bacteria. Although promising, these methods face challenges like a lack of understanding, standardization and public acceptance. Their potential, however, could transform how we manage antibiotic-resistant diseases.