Honey: Antimicrobial actions and role in disease management

Abstract

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.