Antibacterial Honey: in-vitro Activity Against Clinical Isolates of MRSA, VRE, and Other Multiresistant Gram-negative Organisms
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Disclosure: Mr. Cutting has acted as a paid consultancy for Medihoney and Dermasciences.
The media regularly reminds both the public and healthcare professionals of the dangers infection poses to good health, in particular the difficulties in successfully treating infection caused by multiresistant microorganisms.The development of bacterial resistance to antibiotic therapy is understood to be a natural occurrence. The emergence of resistant strains of bacteria and the ensuing management challenges are compounded by the fact that the development of new antibiotics has decreased in recent years.1 This situation prompts revisiting traditional approaches to infection management and use of those antimicrobials where the emergence of resistant strains has not been demonstrated and is highly unlikely to occur.
More recently, interest in honey as a therapeutic agent has undergone a renaissance. Molan,2 in a review article on honey used as a wound dressing, eloquently presented an array of supportive evidence ranging from case studies to randomized controlled trials that clearly indicates the value of honey in wound care—particularly its antibacterial activity.Molan concludes that the antibacterial activity of honey “rapidly clears infection and protects wounds from becoming infected.”2 This statement brings into sharp belief the antibacterial potency of honey and its value as a therapeutic agent in wound care. This notion is supported in a 2005 report the Australian government commissioned that states “honey has been successfully used on infections not responding to standard antiseptic and antibiotic therapy” and that the full potential of honey will be recognized as the number of antibiotic resistant bacteria increases.3
The antibacterial activity of honey has been related to 4 properties (Figure 1).
Honey appears to offer distinct advantages over “traditional” antibiotic therapy. Nonetheless, it is important to remember that although natural honey from the comb is antibacterial, it is not medical grade and should not be used in wound care. Medical grade honey is filtered, gamma irradiated, and produced under exacting standards of hygiene.
All honeys are not the same and do not possess the same therapeutic advantages; therefore, honey should not be considered as a generic term.6 Medihoney™ Antibacterial Honey (Medihoney™ Pty LTD, Richlands, Australia) is a standardized medical honey that is available in many countries including Australia, United Kingdom, Finland, Germany, Austria, and Turkey. It is selected for its antibacterial activity and predominantly sourced from Leptospermum species. Sterility of products is validated against international standards and products are manufactured to meet international quality system requirements. The antibacterial activity of Medihoney is validated for the shelf life of the product, complying with the European Medical Device Directive. The Maori (Polynesian settlers of New Zealand) vernacular name for Leptospermum honey is manuka, the name by which it is more popularly known.
Although the antibacterial activity of honey is recognized, potency varies between types.7 Relevant microbiological data is required in order to better understand the antibacterial activity of specific types of medical honey—particularly its impact on resistant bacterial strains.
Aim. An in-vitro study was initiated in order to gain insight into the antibacterial activity of Medihoney antibacterial honey against a range of multiresistant organisms. Methods A challenge set of 130 clinical isolates with multiple antibiotic resistances was prepared (Figure 2).
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