Shelby Beckwith - Research Paper

Medical-Grade Honey Antibiotic resistance has become an extreme epidemic around the world, due to the overprescribing of antibiotics (Mayo Clinic, 2018). When you take an antibiotic it kills some of your good bacteria, but not all of it. The bad bacteria that are not killed can actually mutate and lead to a strain of bacteria that is resistant to antibiotic drugs, which are known as a superbug. Antibiotics are used when an infection is present in an individual; a patient with a lifethreatening wound is an example of when an antibiotic would be used. An open wound can become the host for microorganisms that can cause an infection. If necrosis begins, it can lead to the death of tissue and potentially of the patient. Due to the antibiotic resistance epidemic, prescription medication is unable to kill certain strains of bacteria. Therefore, researchers are turning to century-old methods of wound care, such as the use of raw honey. The health benefits of raw honey include; getting antioxidants, assisting the digestive system, treating sore throats, helping fight against gingivitis and many more. For centuries, raw honey was used for wound care, before antibiotics were discovered (Oropeza, 2014). Once antibiotics were discovered, people began to believe that natural remedies were no longer needed… until now. Honey can be used to treat numerous infections. The use of honey currently is used to fight against bacterial and fungal infections. The properties in honey also contribute to the healing of wounds. It kills pathogens as well as fungi and yeasts,“this makes it useful against various organisms, including drug-resistant organisms such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus”(Oropeza, 2014, p. 59). For this reason, honey is now becoming an alternative for patients who do not want surgery but, have mild to life-threatening wounds. In one case study, a woman who was 100 years of age had a traumatic lower leg wound which was dressed with a plant-based material

called oxidized regenerated cellulose (ORC) and gauze to help the wound heal faster (Bayron, Gallagher, & Cardenas, 2019). After two days her skin was in necrosis, which is the death of skin tissue. The treatment of the necrosis required intensive cleaning of the wound, however, the cleaning was limited due to the patient’s and her having hypersensitivity pain disorder which is damage of sensory pathways to your central nervous system (Bayron et al., 2019). Therefore, the female patient had to undergo wet dressings for at least two weeks which could cause more bacteria to live in the wound. In addition to hypersensitivity pain disorder, surgery to help the wound to heal was out of the question because of the patient’s age which meant she was at high risk of complications from the sedation that would be used during surgery. The course of treatment for the patient was active leptospermum honey (ALH) gel on the wound, and it was changed every three days. Following each new treatment of the gel, the wound dissipated with time. With ALH gel, it took 10 weeks for the wound to fully heal, which is lengthy and a downside with the use of honey. Although ALH gel has many benefits like, it allows more blood flow to the wound, decreases the amount of pain associated with the wound and is also an anti-inflammatory. These benefits outweigh the drawbacks with regard to the time it takes for the wound to heal (Bayron et al., 2019). The way in which honey works for wounds is simple. Since honey has a high sugar content, it creates a membrane called osmotic gradient that dehydrates bacteria which hinders the bacteria growth (Whitworth, 2018). This is important because the acidity of honey must have a pH level of 3.2 and 4.5. Once applied to the wound, the blood releases oxygen which promotes the wound to heal. “An acidic pH also reduces the presence of substances called proteases that impair the wound healing process” (Whitworth, 2018, para. 1). Physicians and clinicians cannot

use honey that can be purchased at the supermarket. Medicinal use of honey must be raw, specifically, raw Manuka honey. This honey is special because it contains methylglyoxal. Methylglyoxal is an antibacterial component that gives honey its antibiotic quality (Whitworth, 2018). The Methylglyoxal compound kills bacteria, which enables the compound to then pass through the skin and bacteria, to help repair the tissue. Honey is excellent for treatment of first degree burns, second degree burns, and post-operative wounds more so than any antibiotic can. However, since the use of raw honey is new to the medical world researchers do not know if honey can help other types of wounds (Medical Plus, 2018). Raw Manuka honey is gaining popularity, as is a wound paste called Medihoney. Medihoney is an over the counter manuka honey wound and burn gel. A study that was conducted wanted to see the interaction between Medihoney, and Rifampicin which is an antibiotic to treat several infections and is used along with other medications to help fight against bacteria that is resistant to antibiotics (Müller et al., 2013). Methicillin-resistant Staphylococcus aureus (MRSA), which is a flesh-eating disease, has become an urgent health problem. In order to see if honey and an antibiotic together will kill MRSA researchers used a time-kill experiment. They started with just Medihoney and MRSA, it slowed down the bacterial growth of the infection, by 24 hours it was at the same level as no treatment. Next was just the antibiotic of rifampicin which also prevented bacteria to grow for up to 8 hours, however, by 24 hours it was at the same level as Medihoney and no treatment. The last experiment was a combination of both honey and antibiotic. Both significantly decreased the colony-forming unit (CFU) compared to Medihoney and rifampicin, the bacteria did not grow until 48 hours after the application of both. The results were interesting needless to say, with the antibiotic of rifampicin the bacteria has the ability to grow after 24 hours. With Medihoney the bacteria was hindered from growing

until 24 hours. Lastly the combination of both prevented MRSA to grow up to 48 hours, however, this is not helpful since the infection still has the ability to grow. As more bacteria become resistant to antibiotics more life-threatening wounds will not be able to heal properly. As researchers dig deeper into medical-grade honey and its uses, they have also discovered that it treats coughs, diabetes, ulcers in the mouth that have been caused by cancer treatment, and stomach ulcers that have been caused by an infection (Oropeza, 2014). One significant finding of honey is how it can treat acne (Semprini et al., 2016). A twelve-week trial testing study was organized to find how effective Honevo, a treatment with “90% medical-grade kanuka honey, and 10% glycerine (honey product)” (Semprini et al., 2016, p. 6) using it as a acne treatment. The study had 136 participants from 16 to 40 years old who has struggled with acne, each participant was randomly assigned which treatment they would receive. During the twelve week trial period, all the participants applied an antibacterial soap twice a day for the entire trial period. The honey group then applied Honevo right after washing their faces. After the twelve weeks, 7.6% of the participants in the honey test group and the control group had a 2% improvement of their facial acne (Semprini et al., 2016, p. 6). However, this is such a small group and percentage of improvement the trial did not find additional evidence to support that the use of medical-grade honey, glycerine, and antibacterial soap is more effective than just using antibacterial soap to treat acne. With all the hype of honey and how it is becoming a miracle worker, there may be no results for how honey works on other infections like peritonitis. According to M. Ellis with Medical News Today (2018), a trial has been published that patients who have wounds but are on dialysis have seen no advantages or great effects when using medical grade honey. Honey would be beneficial because dialysis carries the risk for peritonitis, a infection in the catheter or the

lining of your abdominal cavity called the peritoneum. When peritonitis is present in an individual it is typically treated with antibiotics, however, not all antibiotics may be used in during dialysis, and there are only a few antibiotics can be used to treat the infection (Ellis, 2013). In addition, honey is becoming regular use in the medical field because it is cheap and effective. Researchers in Australia gathered 371 patients from 26 medicals clinics in Australia and New Zealand to compare the antibiotic treatment for peritonitis and medical-grade honey (Ellis, 2013). The honey was inserted into the patient through the use of a catheter. Ten milligrams of honey was inserted into 186 of the patients daily. The other 185 of the patients were tested for Staphylococcus aureus if the test came back positive they were treated. If the test was to be negative, the patient received basic wound care. At the conclusion of the study, there was no time difference of the infection being gone between the two groups. The group that used honey averaged 16 months and the control group averaged 17 months before the infection had completely dissipated. Some interesting results that were noticed were patients who had diabetes took about 11 months for the infection to be gone, however, the risk of infection was doubled for diabetic patients in the control group. As antibiotic resist becomes more problematic, based on the case studies, honey is clearly a good alternative to prevent infections. However, the use of honey needs to be on a case by case basis. When doctors are presented with patients who have difficult wounds ALH gel would be an excellent treatment option moving forward. In addition to MRSA being on the rise, doctors can greatly benefit from Medihoney and rifampicin. As honey has been helpful in these situations, in the future doctors will need to look at the ways honey can treat the infections mentioned, as well other infections. In addition honey is an effective alternative for wound care and has the

potential of being beneficial for other treatments. As doctor’s encounter more diseases that are resistant to antibiotics they will need to look to the past for ways to treat their patients.

References Bayron, J., Gallagher, E. K., & Cardehas, L. (2019). Medical-grade honey as an alternative to surgery: A case series. 31(2), 1-11. Retrieved from https://www.woundsresearch.com/article/medical-grade-honey-alternative-surgery-caseseries Ellis, M. (2013, October 11). Honey no better than antibiotics in patients with kidney failure. Retrieved from https://www.medicalnewstoday.com/articles/267288.php

Mayo Clinic. (2018, February 20). What Exactly is Antibiotic Resistance? Retrieved from https://www.cdc.gov/drugresistance/about.html Medical Plus. (2018). Honey. Retrieved from https://medlineplus.gov/druginfo/natural/738.html Müller, P., Turnbull, L., Schlothauer, C. R., Carter, A. D., Whitchurch, B. C., & Harry, J. E. (2013). Synergism between Medihoney and Rifampicin against Methicillin-Resistant Staphylococcus aureus (MRSA). Journals PLOS|One, 1-23. https://doi.org/10.1371/journal.pone.0057679 Oropeza, K. (2014). “What’s the buzz about medical- grade honey?” Nursing, 44(7), 59. doi:10.1097/01.NURSE.0000450793.03226.fc Semprini, A., Braithwaite, I., Corin, A., Sheahan, D., Tofield, C., Helm, C., … Montgomery, B., Fingleton, J., Weatherall, M., & Beasley, R. (2016). Randomised controlled trial of topical kanuka honey for treatment of acne. BMJ Open, 6(2), 1-6. doi:10.1136/bmjopen2015-009448 Whitworth, G. (2018, November 16). Honey on wounds: When, how, safety, and effectiveness. Retrieved from https://www.healthline.com/health/honey-on-wounds#effectiveness