Abstract
Skin and chronic wound infections caused by highly antibiotic resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) are an increasing and urgent health problem worldwide, particularly with sharp increases in obesity and diabetes. New Zealand manuka honey has potent broad-spectrum antimicrobial activity, has been shown to inhibit the growth of MRSA strains, and bacteria resistant to this honey have not been obtainable in the laboratory. Combinational treatment of chronic wounds with manuka honey and common antibiotics may offer a wide range of advantages including synergistic enhancement of the antibacterial activity, reduction of the effective dose of the antibiotic, and reduction of the risk of antibiotic resistance. The aim of this study was to investigate the effect of Medihoney in combination with the widely used antibiotic rifampicin on S. aureus. Using checkerboard microdilution assays, time-kill curve experiments and agar diffusion assays, we show a synergism between Medihoney and rifampicin against MRSA and clinical isolates of S. aureus. Furthermore, the Medihoney/rifampicin combination stopped the appearance of rifampicin-resistant S. aureus in vitro. Methylglyoxal (MGO), believed to be the major antibacterial compound in manuka honey, did not act synergistically with rifampicin and is therefore not the sole factor responsible for the synergistic effect of manuka honey with rifampicin. Our findings support the idea that a combination of honey and antibiotics may be an effective new antimicrobial therapy for chronic wound infections.
Highlights
Infectious diseases continue to take a toll on human health and life expectancy
Synergistic Activity between Medihoney and Rifampicin The antimicrobial activity of Medihoney and manuka honey was confirmed by determining the minimum inhibitory concentration (MIC) against S. aureus NCTC8325
The Minimal Inhibitory Concentration (MIC) of rifampicin and Medihoney for the clinical isolates were similar, ranging from 6–8% honey and 0.039–0.078 mg/mL rifampicin (Table S1) and are comparable to MICs reported in the literature [44,45,46]
Summary
Infectious diseases continue to take a toll on human health and life expectancy. In the western world, increased longevity and health complications due to the sharp rise in obesity and diabetes have made chronic wound infections problematic. In the United States, chronic wounds affect 6.5 million patients and are estimated to cost US$25 billion annually, with significant increases expected in the future [1]. Treatment of these infections is becoming increasingly difficult due to antibiotic resistance to currently available drugs [2]. Strains of methicillin-resistant S. aureus (MRSA) have become increasingly common and the spread of these represents a serious health threat [6]. Commercial development of new classes of antibiotics has diminished over the past 15 years and few pharmaceutical companies remain active in this area [7]. There is an urgent need for new approaches to treat these infections
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
