Table 1.

Summary of papers analyzed following the PRISMA-informed literature search.

Title	Test Agent	Biofilms	Results Summary	Reference
Maggot excretions/secretions are differentially effective against biofilms of Staphylococcus aureus and Pseudomonas aeruginosa	ES	S. aureus P. aeruginosa	A quantity of 0.2 µg of ES abolished S. aureus biofilm formation: 8 h incubation. Degradation of P. aeruginosa biofilms > 10 h incubation; required 10-fold more ES than S. aureus biofilms. Boiling of ES abrogated their effects on S. aureus but not on P. aeruginosa biofilms.	[84]
Disruption of Staphylococcus epidermidis biofilms by medicinal maggot Lucilia sericata excretions/secretions	ES	S. epidermidis	In the presence of ES, S. epidermidis 1457 and 5179-R1 nascent biofilm formation was inhibited, and pre-formed biofilms were disrupted. ES activity was temperature- and time-dependent, inactivated by heat treatment, and disruption depended on the mechanism of intercellular adhesion.	[85]
The Influence of Maggot Excretions on PAO1 Biofilm Formation on Different Biomaterials	ES	P. aeruginosa	Maggot ES prevents and inhibits PAO1 biofilm formation and degrades existing biofilms. ES still had considerable biofilm-reduction properties after storage at room temperature for 1 month. ES from instar-3 maggots were more effective than ES from instar-1 maggots.	[86]
Combinations of maggot excretions/secretions and antibiotics are effective against Staphylococcus aureus biofilms and the bacteria derived therefrom	ES	S. aureus	A quantity of 20–200 mg/L ES eradicated S. aureus biofilms within 3 h. Enhanced antimicrobial activity of daptomycin against biofilms.	[87]
Maggot excretions inhibit biofilm formation on biomaterials	ES	S. aureus S. epidermidis K. oxytoca E. faecalis E. cloacae	The presence of excretions/secretions reduced biofilm formation on all biomaterials. A maximum of 92% of biofilm reduction was measured.	[88]
Blow fly Lucilia sericata nuclease digests DNA associated with wound slough/eschar and with Pseudomonas aeruginosa biofilm	ES	P. aeruginosa	A quantity of 20 µg/mL ES resulted in an ~50% reduction in pre-formed biofilms.	[89]
Excretions/secretions from bacteria-pretreated maggot are more effective against Pseudomonas aeruginosa biofilms	ES	P. aeruginosa	Researchers stated that ES obtained from larvae pre-treated with 1 × 106 CFU/mL P. aeruginosa displayed enhanced inhibition of nascent biofilm formation.	[90]
Lucilia sericata chymotrypsin disrupts protein adhesin-mediated staphylococcal biofilm formation	Recombinant larval derived enzyme	S. aureus S. epidermidis	Chymotrypsin derived from maggot excretions/secretions disrupts protein-dependent bacterial biofilm-formation mechanisms.	[91]
Chronic Wounds, Biofilms and Use of Medicinal Larvae	L. sericata larvae	S. aureus P. aeruginosa	Biofilms of P. aeruginosa and S. aureus grown on dermal pig explants were eradicated (6-log reduction) following a 48-h application of live L. sericata larvae. Following 24 h exposure, a 5-log reduction was observed.	[92]
Selective Antibiofilm Effects of Lucilia sericata Larvae Secretions/Excretions against Wound Pathogens	ES	S. aureus E. cloacae P. mirabilis	Maggot ES at 100 mg/mL concentration significantly reduced biofilm formation and disrupted established biofilm of E. cloacae. Heat-treated ES did not show any antibiofilm activity towards E. cloacae. Similar results were obtained in the case of S. aureus; however, the heat-treatment of maggot ES did not affect its antibiofilm activity.	[93]
Antibacterial and antibiofilm effects of fatty acids extract of dried Lucilia sericata larvae against Staphylococcus aureus and Streptococcus pneumoniae in vitro	Fatty acid extraction from dried and crushed L. sericata larvae	S. aureus S. pneumoniae	The fatty acid extract successfully inhibited the formation of biofilm and degraded mature biofilm produced by both species tested. Antibiofilm effects were concentration dependent.	[94]
Maggot Extract Interrupts Bacterial Biofilm Formation and Maturation in Combination with Antibiotics by Reducing the Expression of Virulence Genes	L. sericata extract	S. aureus P. aeruginosa	Significant reduction in observed biofilms in ex vivo human-dermal-skin explant model for both bacteria treated.	[95]