Are there feasible prospects for manuka honey as an alternative to conventional antimicrobials?
Expert Rev Anti Infect Ther, 2012 Jun;10(6):623-5.
Antimicrobial agents have been used with varying success in the treatment of wound infections for thousands of years. Without knowing the identity of wound pathogens, ancient civilizations developed crude remedies to manage infected wounds from locally available materials .
During the 19th century the discovery of antiseptics and the introduction of aseptic surgery allowed significant improvements in wound management, but the advent of antibiotics gave rise to optimism that wound infection would no longer be feared.
However, the continued emergence of antibiotic-resistant and multiple drug-resistant microbial strains (some with additional antiseptic resistance) has shaken that belief and there is increasing alarm at the prospect that wound infections may once again become uncontrollable. Strategies to overcome this situation include searching for new antibiotics, modifying existing antibiotics, finding unique microbial target sites and designing appropriate novel inhibitors, as well as evaluating ancient remedies.
Inadequate investment by pharmaceutical organizations has curtailed these options. However, re-examining former treatments has yielded some promising novel therapeutic agents with essential oils, maggots and garlic under investigation. Now honey, which was an ancient wound treatment, is being used in conventional medicine…
Despite accumulating evidence of the efficacy of manuka honey in inhibiting wound pathogens in vitro, substantive in vivo data are required because practitioners influenced by evidence-based medicine are likely to need objective clinical evidence before they risk adding manuka honey to their armament as a first-choice topical treatment. Since laboratory studies carry little weight in the hierarchy of evidence, suitable funds must be found to support clinical investigation. An effective topical antimicrobial could have a significant impact on the fight to limit the spread of MRSA in healthcare establishments.
Comparison of manuka honey with mupirocin in randomized clinical trials is now needed to investigate the efficacy of decolonization of MRSA from colonized wounds or nasal carriage. Broad-spectrum activity against wound pathogens, lack of selection of honey-resistant mutants and lack of cytotoxicity are all good reasons to consider using manuka honey clinically.