Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series

Abstract

Diabetic ulcers are at risk of becoming chronic and infected, as diabetics have hampered vascular structures, limiting oxygen and nutrient supply. These wounds can lead to pain, malodor, functional problems, and amputation. The current rise in antibiotic resistance demands for complementary therapies. Medical-grade honey (MGH) forms an attractive option because of its antimicrobial and pro-healing properties. We aim to show the beneficial effects of MGH in infected diabetic ulcers. We present six patients with infected diabetic ulcers, of which some were at risk of (further) amputation. Previous treatments with antibiotics, silver and alginate dressings, surgical closure, and maggot therapy were ineffective; therefore, the treatment was switched to the application of MGH. MGH therapy typically reduced the malodor in a couple of days and controlled infection within 2–3 weeks. MGH also enhanced wound healing by promoting granulation tissue formation, angiogenesis, and re-epithelialization, by decreasing inflammatory and oxidative stress and providing nutrients. Together, wound healing was enhanced, and the patient’s quality of life improved. MGH is safe and cost-effective for treating complicated diabetic wounds with (antibiotic-resistant) infections and at risk of amputation. MGH forms a promising alternative or complementary therapy to replace antibiotics for treating locally infected wounds.

Antifungal Activity of a Medical-Grade Honey Formulation against Candida auris

“…Even at 6.25-fold dilution, this medical-grade honey formulation induced a more than 1-log reduction in all Candida strains. This medical-grade honey formulation effectively treats infected human wounds with (multiresistant) bacteria [ 16 ] and the canine otitis externa [ 26 ]. Therefore L-Mesitran ® Soft is a potential candidate for the treatment of wounds and skin colonized with C. auris and other Candida species.…”

“…CE- and FDA-approved L-Mesitran ® Soft [ 16 , 19 ] (formulation containing 40% medical-grade honey, hypoallergenic lanolin, propylene glycol, PEG 4000, and vitamins C and E), pure medical-grade honey following strict guidelines [ 10 ] (honey component of ® L-Mesitran ® Soft, Brazilian blossom honey) and unprocessed (non-sterilized) local honey (provided by local beekeeper from Mook, the Netherlands) were included in this study. These compounds were suspended in 1× RPMI 1640 medium to reach final concentrations of 16% and 40% ( v / v ) after the addition of Candida suspensions.…”

“…The antimicrobial activity of honey is based on multiple mechanisms and involves its osmotic activity, low pH, the formation of hydrogen peroxide, and the presence of various phytochemicals, such as alkaloids and flavonoids (caffeic acid, quercetin, pinobanksin, chrysin and galangin), and bee-added peptides, such as apidaecin and bee-defensin-1, that can exert an antimicrobial effect [ 14 , 15 ]. Antimicrobial resistance towards honey is not reported due to the versatility of the antimicrobial mechanisms [ 16 ]. The exact composition of honey highly depends on the geographic origin and the type of nectar, and as such, the antimicrobial activity can vary greatly between different types of honey [ 15 ].…”

Honey: Another Alternative in the Fight against Antibiotic-Resistant Bacteria?

“…In addition, in vivo studies demonstrated that this type of honey was able to reduce the microbial colonization of skin of healthy volunteers 100-fold [107]. More recently, L-Mesitran products, formulated with medical-grade honey, demonstrated in vitro their activity against MRSA [99], and in vivo their promising applicability to treat chronic diabetic ulcers, preventing amputations derived from antibiotic-resistant infections [108].…”

<p>Honey Combination Therapies for Skin and Wound Infections: A Systematic Review of the Literature</p>

“… 47 Furthermore, Nair et al (2020) reported on the successful healing of diabetic foot ulcers (six patients) following topical application of L-Mesitran. 48 The wounds had previously failed to respond to a range of other treatments including antibiotics. Another case study reported on successful eradication of infection in an MRSA infected titanium mesh in an incisional hernia in a 70-year-old female patient treated with L-Mesitran.…”