Are there feasible prospects for manuka honey as an alternative to conventional antimicrobials?
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.
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