The Inhibitory Effects Demonstrated by Manuka Honey on Biofilms: How Manuka Honey May Soon Replace Conventional Antibiotic Therapy

Introduction: The surge of antibiotic-resistant bacteria has raised substantial concerns over how to effectively and efficiently control antibiotic-resistant bacteria capable of secreting biofilms. A biofilm can be defined as a self-producing extracellular matrix (Carter, et, al., 2016). Manuka honey, an alternative to conventional antibiotics, has proven successful in inhibiting planktonic cells and killing bacteria living under the protection of biofilms (Brudzynski & Sjaarda, 2015

Honey anti-inflammatory factor identified

Four different brands of honey wound dressings are now on sale internationally as registered medical devices, all made from manuka honey because of its well-established reputation as an antibacterial agent. What is not so well known is that manuka honey also has a potent anti-inflammatory activity, and that this is very important in the treatment of wounds

Preliminary Analysis of the Anti-biofilm Efficacy of Manuka Honey on Extended Spectrum Β-lactamase Producing Escherichia Coli Tem-3 and Klebsiella Pneumoniae Shv18, Associated with Urinary Tract Infections

open access articleUrinary Tract Infections (UTIs) are one of the most common infections in the UK and many other parts of the world. The prevalence of the Extended Spectrum β-Lactamases (ESBLs) producing UTIs, combined with their ability to form a bio film, has significantly risen and is limiting therapeutic options. This study investigated the anti-bio film activity of Manuka honey on two ESBL producing pathogens, Escherichia coli TEM-3 and Klebsiella pneumonia SHV18, commonly found in UTIs. The ESBL production was confirmed by the double disk synergy method used to confirm the ESBL production. The antibacterial activity of Manuka honey was determined using the agar well diffusion method. The Minimum Inhibitory Concentration (MIC) was established using serially diluted honey ranging from 50% to 1.56%. The effect of Manuka honey on the pathogen bio films was analysed using the Tissue Culture Plate method, with an established MIC and under 24h incubation with the honey. The results indicated that K. pneumonia SHV18 is a stronger bio film producer than E. coli TEM 3. 50% (w/v) MIC Manuka honey appears to fully prevent the plank tonic growth of both strains. A significant reduction of 81% of the E. coli TEM3 (p < 0.001) and 52% of the K. pneumonia SHV18 (p = 0.001) bio film biomass was observed. The E. coli bio films were found to be more sensitive to the 50% (w/v) honey dilution than those produced by K. pneumonia. The study indicated the anti-bio film potency of Manuka honey and its potential to become an alternative treatment for the ESBL producing pathogens associated with UTIs

The evidence and the rationale for the use of honey as wound dressing

Although there are now several brands and types of honey wound-care products available as registered medical devices, there is little promotional advertising of honey products for wound care. The misconception that there is no evidence to support the use of honey, which seems to be quite common, may be due to this lack of advertising, and to the systematic reviews that have been published on honey concluding that the evidence is of low quality and/or there is a need for more evidence. However, the same lack of high-quality evidence exists with all the other options that clinicians have for dressing wounds. This places practitioners in a quandary. When clinical evidence of the highest level is not available, then decisions on modes of treatment need to be based on whatever evidence there is available. This review outlines the 16 randomised controlled trials (RCTs) of honey in wound care published since Molan reviewed the previous 17 in 2006, which bring the total of participants in the trials up from 1,965 to 3,556 and broadens the range of types of wounds on which trials with honey have been conducted. Another important factor influencing the choice by clinicians of which product to use on a wound is scientific rationale. This review covers the evidence and explanation of mode of action for various bioactivities in honey which aid wound healing: a very broad-spectrum antimicrobial activity that is effective on antibiotic-resistant strains; activation of autolytic debridement; anti-inflammatory activity; antioxidant activity; stimulation of growth of cells for tissue repair; and an osmotic action. The need for standardisation of these bioactivities is discussed

Claims for manuka honey activity

Whilst standards have been established to define whether or not a honey can be called manuka, little progress has been made with establishing a standard for describing the antibacterial activity of manuka honey. In New Zealand and in other countries there are laws that protect consumers from being misled, and laws to protect traders from unfair competition. Anyone making a claim for honey having a particular level of antibacterial activity when selling it needs to take care that they are not falling foul of these laws. This article has been written to ensure that false claims are not made unknowingly

Using honey to heal diabetic foot ulcers

Diabetic ulcers seem to be arrested in the inflammatory/proliferative stage of the healing process, allowing infection and inflammation to preclude healing. Antibiotic-resistant bacteria have become a major cause of infections, including diabetic foot infections. It is proposed here that the modern developments of an ancient and traditional treatment for wounds, dressing them with honey, provide the solution to the problem of getting diabetic ulcers to move on from the arrested state of healing. Honeys selected to have a high level of antibacterial activity have been shown to be very effective against antibiotic-resistant strains of bacteria in laboratory and clinical studies. The potent anti-inflammatory action of honey is also likely to play an important part in overcoming the impediment to healing that inflammation causes in diabetic ulcers, as is the antioxidant activity of honey. The action of honey in promotion of tissue regeneration through stimulation of angiogenesis and the growth of fibroblasts and epithelial cells, and its insulin-mimetic effect, would also be of benefit in stimulating the healing of diabetic ulcers. The availability of honey-impregnated dressings which conveniently hold honey in place on ulcers has provided a means of rapidly debriding ulcers and removing the bacterial burden so that good healing rates can be achieved with neuropathic ulcers. With ischemic ulcers, where healing cannot occur because of lack of tissue viability, these honey dressings keep the ulcers clean and prevent infection occurring

A review of Leptospermum scoparium (Myrtaceae) in New Zealand

Information about Leptospermum scoparium (Myrtaceae), the most widespread and important New Zealand indigenous shrub species, is reviewed. L. scoparium is a variable species, requiring more study of the genetically based differences between New Zealand populations and the affinity of these populations to Australian populations and other closely allied Australian species. Improved understanding of the species’ variation will assist both its conservation roles and economic uses, and the need to sustain genetically distinct varieties is emphasised. Ecologically, the species has a dominant role in infertile and poorly drained environments, and a wider occurrence as a seral shrub species in successions to forest where it may be regarded as a woody weed of pasture or a useful species for erosion control, carbon sesquestration, and vegetation restoration. The main economic products derived from the species are ornamental shrubs, essential oils, and honey. The species’ development as an ornamental plant and further definition of the pharmacologically active components are recommended as priority areas for research

Honey: Antimicrobial actions and role in disease management

The ancient treatment of dressing infected wounds with honey is rapidly becoming re-established in professional medicine, especially where wounds are infected with antibiotic-resistant bacteria. This is because of the demonstrated sensitivity of such bacteria to the antibacterial activity of honey, which is not influenced by whether or not strains are resistant to antibiotics. Honey has been found to have a very broad spectrum of activity, but its potency of antibacterial activity can vary greatly. In most honeys the antibacterial activity is due to enzymatically produced hydrogen peroxide and thus the potency of its antibacterial activity can be decreased by catalase present in an open wound. Manuka honey has an antibacterial component derived from the plant source. Manuka honey with a quality-assured level of antibacterial activity is being used by companies marketing honey products for wound care that are registered with the medical regulatory authorities in various countries. Such honey can be diluted IO-fold or more and still completely inhibit the usual wound-infecting species. There is a large amount of clinical evidence for the effectiveness of honey in clearing infection in wounds, and some clinical evidence of its effectiveness in treating other infections. Although the antibacterial potency of honey is insufficient to allow its use systemically, there are various clinical applications besides wound care in which it is used topically or where it does not get excessively diluted, such as for treatment of gastritis, enteritis, gingivitis, ophthalmological infections and bronchial infections. In most of these applications the anti-inflammatory activity of honey is of additional benefit in decreasing the inflammation resulting from infection. Additional clinical research is needed to provide better evidence of the effectiveness of honey in these therapeutic applications of honey

Debridement of wounds with honey

Honey has been used as a debriding agent since ancient times. Its debriding properties have been rediscovered in more recent times, with various case reports published in the latter decades of the 20th century describing its effectiveness in cleaning up wounds. More recently its effectiveness has been compared with that of modern debriding agents, and honey has been found to work more rapidly than all except larval therapy. A randomised controlled trial demonstrated significantly better debriding with honey than with hydrogel. Other trials have shown that honey is a good alternative to surgical debridement for the treatment of necrotising fasciitis in the genital region. Seven case series and ten single case studies have also been published in which the effectiveness of honey in debriding wounds was reported. A prophylactic action of honey has also been reported, where in a randomised controlled trials comparing honey with silver sulfadiazine for the treatment of burns there was no eschar formed with honey but there was eschar formed in the cases treated with silver sulfadiazine. A similar finding has been reported in an animal model, where adjacent experimental wounds were kept clean with honey-soaked gauze but formed thick dense scabs where treated with saline-soaked gauze. The mechanism of action of honey is as yet unknown, but appears to be by way of stimulating autolytic debridement. Additional advantages using honey rather than other moist debridement are that its antibacterial action prevents bacterial growth from being encouraged, and its osmolarity prevents maceration of periwound skin

Clinical usage of honey as a wound dressing: An update

Honey is an ancient treatment that is increasingly earning its place in modern wound care. Evidence suggests it compares with other dressings in terms of its antibacterial properties, ease of use and ability to promote a moist environmen