Safety of transtympanic application of 4 % manuka honey in a chinchilla animal model

In vitro antibacterial activity of the manuka essential oil from Leptospermum scoparium combined with Tris-EDTA against Gram-negative bacterial isolates from dogs with otitis externa

BACKGROUND

The increasing prevalence of antimicrobial resistance among bacteria in dogs with otitis externa has led to a need for novel therapeutic agents.

HYPOTHESIS/OBJECTIVE

To examine the antibacterial effects of manuka oil combined with ethylenediaminetetraacetic acid-tromethamine (Tris-EDTA) against Gram-negative bacteria isolates from dogs with otitis externa.

METHODS AND MATERIALS

A total of 53 clinical isolates including Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae ssp. pneumoniae and Proteus mirabilis. Antimicrobial susceptibility was determined using disk diffusion; the minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of manuka essential oil, with or without Tris-EDTA, were investigated.

RESULTS

A total of 44 isolates were resistant to at least one antibiotic and 19 strains were multidrug-resistant, with resistance to at least one agent in three or more antimicrobial classes. The MICs and MBCs of manuka oil alone were ≥1% (v/v) and ≥2% (v/v), respectively. There was no antimicrobial effect of Tris-EDTA (1.125:0.3 mg/mL) without manuka oil. However, the combination of manuka oil with Tris-EDTA significantly decreased the MICs (ranging from 0.06% to 0.5%, v/v; P < 0.001) and MBCs (ranging from 0.06% to 1%, v/v; P < 0.001). There also was no significant difference between multidrug-resistant and nonresistant bacterial isolates in terms of the antimicrobial activity of manuka oil with Tris-EDTA.

CONCLUSIONS AND CLINICAL IMPORTANCE

The study findings suggest that manuka oil, especially when combined with Tris-EDTA, may be a promising alternative therapeutic option for Gram-negative otic pathogens. Clinical studies are needed to assess potential for in vivo ototoxic effects and efficacy.

Honey as a Treatment in Otorhinolaryngology: A Review by Subspecialty

OBJECTIVES

To provide an up-to-date review of honey's effectiveness and potential applications in otorhinolaryngology.

METHODS

A literature search of the online databases PubMed, EMBASE, and Cochrane Central Register of Controlled Trials was conducted.

RESULTS

Sixty-three studies were identified within head and neck surgery (n = 23, 36%); pediatric otolaryngology (n = 18, 29%); rhinology, sinus, and skull base surgery (n = 11, 17%); otology (n = 6, 10%), facial plastic and reconstructive surgery (n = 3, 5%); and laryngology (n = 2, 3%). Studies included 6 meta-analyses, 44 randomized control trials, 5 case reports, and 8 animal models or in vitro studies. Of 55 clinical studies, 50 reported Level 1 evidence (prospective randomized control trials), and 5 reported Level 4 evidence (case series). The evidence level by subspecialty was: head and neck surgery (Level 1 n = 23), pediatrics (Level 1 n = 18), rhinology (Level 1 n = 7, level 4 n = 1), otology (Level 1 n = 1, Level 4 n = 3), facial plastics and reconstructive surgery (Level 4 n = 1), and laryngology (Level 1 n = 2).

CONCLUSIONS

Honey can be used for a variety of otolaryngology conditions. The highest quality meta-analyses support oral honey for prevention and treatment of oral mucositis in cancer patients, cough associated with upper respiratory infection in children, and pain control after tonsillectomy. Further research will likely justify broader applications.

Efficacy of medical grade honey in the management of canine otitis externa - a pilot study

BACKGROUND

The high prevalence of antimicrobial resistance within otic pathogens has created a need for alternative therapies of otitis externa (OE). Evidence suggests that medical grade honey (MGH) may be effective against drug-resistant pathogens.

HYPOTHESIS/OBJECTIVES

The efficacy of a commercial MGH compound was assessed in an open clinical trial. We hypothesized that it would be an effective alternative to conventional treatments.

ANIMALS

Client-owned dogs (n = 15) with a confirmed diagnosis of infectious OE were enrolled in this pilot study.

METHODS

Dogs were prescribed MGH (1 mL daily per ear) until cure was achieved or for a maximum of 21 d. Evaluation was based on weekly clinical scores, cytological progression and owner assessments of pruritus. Swab samples were submitted for culture and susceptibility testing. MGH was tested for biocidal activity against the bacterial isolates.

RESULTS

Medical grade honey promoted rapid clinical progress, with 70% of dogs achieving clinical cure between days 7 and 14 and over 90% having resolved by Day 21. There was a decrease in clinical scores throughout the duration of the trial (P < 0.001) and owner-assessed pruritus also decreased significantly (P < 0.05). In vitro assays of the biocidal activity of MGH showed activity against all bacterial isolates, including meticillin-resistant strains of Staphylococcus pseudintermedius (MRSP) and other species of drug-resistant bacteria.

CONCLUSION AND CLINICAL IMPORTANCE

Medical grade honey was successful in both clinical and laboratory settings, thus demonstrating its potential of becoming an alternative treatment for canine OE.