Medical-grade honey kills antibiotic-resistant bacteria in vitro and eradicates skin colonization.
BACKGROUND
Antibiotic resistance among microbes urgently necessitates the development of novel antimicrobial agents. Since ancient times, honey has been used successfully for treatment of infected wounds, because of its antibacterial activity. However, large variations in the in vitro antibacterial activity of various honeys have been reported and hamper its acceptance in modern medicine.


METHODS
We assessed the in vitro bactericidal activity of Revamil (Bfactory), a medical-grade honey produced under controlled conditions, and assessed its efficacy for reduction of forearm skin colonization in healthy volunteers in a within-subject-controlled trial.


RESULTS
With Bacillus subtilis as a test strain, we demonstrated that the variation in bactericidal activity of 11 batches of medical-grade honey was <2-fold. Antibiotic-susceptible and -resistant isolates of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, and Klebsiella oxytoca were killed within 24 h by 10%-40% (vol/vol) honey. After 2 days of application of honey, the extent of forearm skin colonization in healthy volunteers was reduced 100-fold (P < .001), and the numbers of positive skin cultures were reduced by 76% (P < .001).


CONCLUSIONS
Revamil is a promising topical antimicrobial agent for prevention or treatment of infections, including those caused by multidrug-resistant bacteria.
Kwakman
Paulus H S
PH
Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, The Netherlands.
Van den Akker
Johannes P C
JP
Güçlü
Ahmet
A
Aslami
Hamid
H
Binnekade
Jan M
JM
de Boer
Leonie
L
Boszhard
Laura
L
Paulus
Frederique
F
Middelhoek
Pauline
P
te Velde
Anje A
AA
Vandenbroucke-Grauls
Christina M J E
CM
Schultz
Marcus J
MJ
Zaat
Sebastian A J
SA
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects* / Q000254:growth & development; D006722:Honey; D006801:Humans; D008826:Microbial Sensitivity Tests; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*
D000900:Anti-Bacterial Agents