Antimicrobial activities of Saudi honey against Pseudomonas aeruginosa

The Effect of Selected Bee Products on Adhesion and Biofilm of Clostridioides difficile Strains Belonging to Different Ribotypes

There is an ongoing search for alternative treatments for Clostridioides difficile infections. The aim of the study was to investigate the antibacterial and antibiotic activity of bee products against C. difficile strains with different polymerase chain reaction ribotypes (RTs). The minimum inhibitory concentration (MICs) of Manuka honey 550+, goldenrod honey, pine honey, and bee bread were determined by the broth dilution method. C. difficile adhesion to HT-29, HT-29 MTX, and CCD 841 CoN cell lines was assessed. Biofilm was cultured in titration plates and visualized by confocal microscopy. The MICs of Manuka honey for C. difficile 630 and ATCC 9689 strains and control strain, M 120, were 6.25%, 6.25%, and 1.56% (v/v), respectively; of goldenrod honey, 50%, 50%, and 12.5%, respectively; of pine honey, 25%, 25%, and 25%, respectively; and of bee bread, 100 mg/L, 50 mg/L, and 100 mg/L, respectively. Manuka honey (1%) increased adhesion of C. difficile RT176 strains, and one strain of RT023, to the CCD 841 cell line. Pine honey (1%) increased RT027 adhesion to the HT-29 cell line. Manuka honey, pine honey, and bee bread at subinhibitory concentrations increased the adhesion of C. difficile. Our research proved that bee products are active against the tested strains of C. difficile.

The Antimicrobial Effects of Saudi Sumra Honey against Drug Resistant Pathogens: Phytochemical Analysis, Antibiofilm, Anti-Quorum Sensing, and Antioxidant Activities

Honey exhibited potential antimicrobial activity against multidrug resistant (MDR) bacteria that continues to be a serious health problem. We reported the in-vitro activity of Saudi Sumra honey against clinical pathogenic bacteria and fungi, antibiofilm, anti-quorum-sensing (QS) and antioxidant activities in relation to its phytochemical composition assessed by gas chromatography-mass spectrometry (GC-MS). Broth dilution method and scavenging activities against 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and β-carotene bleaching assays were performed. The GC-MS analysis of Sumra honey showed that 2,4-dihydroxy-2,5-dimethyl-3(2H)-furan-3-one 1-methylcyclopropanemethanol were the major identified phytoconstituents. Sumra honey showed a minimum inhibitory concentration (MIC) to clinical isolates of Staphylococcus aureus including methicillin-resistant Staphylococcus aureus (MRSA) at 300 mg/mL, Pseudomonas aeruginosa (250 mg/mL), Escherichia coli (350 mg/mL) and Acinetobacter baumannii (250 mg/mL); clinical fungal isolates—Candida auris (600 mg/mL) and Cryptococcus neoformans (>1000 mg/mL); wild type fungal isolates—Candida krusei (>1000 mg/mL) and Candida albicans (700 mg/mL). In addition, Sumra honey demonstrated promising inhibition targeting biofilm formation by 59% for Bacillus subtilis, 48% for S. aureus, 38% for E. coli, and 33.63% for P. aeruginosa. The violacein production in Chromobacterium violaceum was reduced to 68%, whereas pyocyanin production in P. aeruginosa was reduced to 54.86% at ½ MIC. Furthermore, Sumra honey exhibited strong antioxidant activities (DPPH − IC50 = 7.7 mg/mL; ABTS − IC50 = 5.4 mg/mL; β-carotene − IC50 = >20 mg/mL). Overall, obtained data highlighted the promising potential therapeutic use of Sumra honey treating infections caused by MDR bacteria and fungi. Moreover, Sumra honey can be a good candidate as an inhibitor agent for bacterial cellular communication in strains of P. aeruginosa and C. violaceum.

Chemical Profile, Antioxidant and Enzyme Inhibition Activities of Natural Saudi Sidr and Talh Honeys

Honey is used since ancient time as a food and to cure many diseases. The present study investigated the chemical constituents, antioxidant and enzyme inhibition activities of natural Saudi Sidr (SH) and Talh (TH) honeys. Beside entire honey samples, ethyl acetate, ethanol and water extracts were prepared. The total polyphenolic content of SH, TH and their extracts was in the range of 2.86-7.21 and 3.80-17.33 mg gallic acid equivalents/g, respectively and the total flavonoids content was in the range of 0.05-1.17 and 0.18-2.38 mg rutin equivalents/g, respectively. Out of the 53 standards analyzed by HPLC, 27 compounds were detected with highest number of compounds identified in the ethyl acetate extract of TH (45 %, 24/53) and SH (26 %, 14/53), respectively. Quinic acid was dominant compound identified in all honey samples with the highest content determined in TH ethanol extract (4454 μg/g). The majority of tested samples possessed considerable anti-radicals and reducing ions capacity with the ethyl acetate extract from TH exerted significantly (p<0.05) the highest activity. All honey samples did not show chelating iron metal property. Honey samples revealed variable enzyme inhibition activity with TH (entire and/or ethyl acetate extract) showed significantly (p<0.05) the highest acetylcholinesterase, butyrylcholinesterase, tyrosinase and α-amylase inhibition activity. In conclusion, ethyl acetate is the best solvent for extraction of bioactive molecules from the two honey types. Moreover, the dark-colored TH contained the highest number of molecules and consequently exerted the best antioxidant and enzyme inhibition activities in most assays.

Saudi Honey: A Promising Therapeutic Agent for Treating Wound Infections

Treatment of wounds, especially chronic ones, is a major challenge in healthcare, with serious clinical and economic burdens. Multiple treatment approaches, including the usage of silver and iodine, have dramatically improved wound healing and reduced the incidence of infection. However, once infected by drug-resistant bacteria, treatment of wounds becomes a serious complication, with limited availability of effective antibiotic drugs, leading to high morbidity and mortality. Therefore, alternative therapeutic agents are required to address this gap in wound management. The introduction of manuka honey as a therapeutic agent against infected wounds was the result of extensive research about its activity against both planktonic and biofilm bacterial growth. Likewise, several types of Saudi honey (e.g., Sidr and Talh) showed promising in vitro and in vivo antimicrobial activity against wound pathogens. This short review summarizes literature that investigated the activity of common types of Saudi honey in relation to wound infections and explores their clinical utility.

Honey in wound healing: An updated review

Wound healing is a complex process with many interdependent pathophysiological and immunological mediators to restore the cellular integrity of damaged tissue. Cutaneous wound healing is the repair response to a multitude of pathologies induced by trauma, surgery, and burn leading to the restoration and functionality of the compromised cells. Many different methods have been employed to treat acute and chronic wounds, such as antimicrobial therapy, as most wounds are susceptible to infection from microbes and are difficult to treat. However, many antimicrobial agents have become ineffective in wound treatment due to the emergence of multiple drug-resistant bacteria, and failures in current wound treatment methods have been widely reported. For this reason, alternative therapies have been sought, one of which is the use of honey as a wound treatment agent. The use of honey has recently gained clinical popularity for possible use in wound treatment and regenerative medicine. With this high demand, a better delivery and application procedure is required, as well as research aiming at its bioactivity. Honey is a safe natural substance, effective in the inhibition of bacterial growth and the treatment of a broad range of wound types, including burns, scratches, diabetic boils (Skin abscesses associated with diabetic), malignancies, leprosy, fistulas, leg ulcers, traumatic boils, cervical and varicose ulcers, amputation, burst abdominal wounds, septic and surgical wounds, cracked nipples, and wounds in the abdominal wall. Honey comprises a wide variety of active compounds, including flavonoids, phenolic acid, organic acids, enzymes, and vitamins, that may act to improve the wound healing process. Tissue-engineered scaffolds have recently attracted a great deal of attention, and various scaffold fabrication techniques are being researched. Some incorporate honey to improve their delivery during wound treatment. Hence, the aim of this review is to summarize recent studies on the wound healing properties of honey.

Bioactive compounds and antibacterial activities in crystallized honey liquefied with ultrasound

The effect of ultrasound on the crystal size, phenols, flavonoids, Maillard products and antibacterial activity of crystallized honeys was studied. Three multifloral honeys (M), one monofloral (MO) and one honeydew (HD) honey were used. Ultrasound was performed at 42 kHz for different times (0, 5, 10 and 15 min). The antibacterial activities were tested against Salmonella typhimurium, Bacillus subtilis, Pseudomonas aeruginosa, Listeria monocytogenes, Staphylococcus aureus and Escherichia coli. In all honeys, the parameters analyzed had significant differences ((P < 0.05)). After 15 min of ultrasound the HD had increments of 44 mg of gallic acid/100 g of honey in phenols, and some M showed increase in flavonoids (5.64 mg of quercitin /100 g of honey) and improvement in inhibition against Salmonella typhimurium was 13.1%. In some honeys the correlation between phenols or flavonoids and antibacterial activity were significant ((P < 0.05)). No correlation was found between Maillard products and antibacterial activity. The ultrasound treatment effect on the crystal size, phenols, flavonoid, Maillard products, and antibacterial activity of crystallized honeys were different in each honey.

The antibacterial activities of honey

Honey is a powerful antimicrobial agent with a wide range of effects. Various components contribute to the antibacterial efficacy of honey: the sugar content; polyphenol compounds; hydrogen peroxide; 1,2-dicarbonyl compounds; and bee defensin-1. All of these elements are present at different concentrations depending on the source of nectar, bee type, and storage. These components work synergistically, allowing honey to be potent against a variety of microorganisms including multidrug resistant bacteria and modulate their resistance to antimicrobial agents. The effectiveness and potency of honey against microorganisms depends on the type of honey produced, which is contingent on its botanical origin, the health of the bee, its origin, and processing method. The application of antibiotics with honey yielded better antimicrobial potential and synergistic effects were noted against biofilms. In medicine, honey has been used in the treatment of surface wounds, burns, and inflammation, and has a synergistic effect when applied with antibiotics. Tissue repair is enhanced by the low pH of honey (3.5-4): causing a reduction in protease activity on the wound site, elevating oxygen release from hemoglobin and stimulating fibroblast and macrophage activity. Furthermore, H2O2 has antiseptic effects, and it disinfects the wound site and stimulates production of vascular endothelial growth factor. The use of honey will clean wounds or burn areas from free radicals and reduces scarring and contractures. The anti-inflammatory and antibacterial potential of honey will keep the injured area moist and as such prevents it from deterioration and fibrosis. Honey can promote fast healing and reduce scarring and is very convenient for plastic surgery. Skin maceration is protected by honey due to its high osmolarity and because it keeps the injury moist. In non-infected areas, honey still reduced pain and inflammation. In general, the use of honey in medical settings has reduced economic loss and provided proven economic benefits by lowering direct costs in comparison to conventional treatments and by using less antibiotics, faster healing and less hospitalization stay. This review is intended to provide an overview of the antibacterial activities of honey and its applications.

Transcriptome Analysis of Pseudomonas aeruginosa Biofilm Following the Exposure to Malaysian Stingless Bee Honey

Introduction

Malaysian stingless bee honey (Trigona) has been aroused as a potential antimicrobial compound with antibiofilm activity. The capability of the gram-negative bacillus P. aeruginosa to sustain a fatal infection is encoded in the bacterium genome.

Methods

In the current study, a transcriptome investigation was performed to explore the mechanism underlying the biofilm dispersal of P. aeruginosa after the exposure to Trigona honey.

Results

Microarray analysis of the Pseudomonas biofilm treated by 20% Trigona honey has revealed a down-regulation of 3478 genes among the 6085 screened genes. Specifically, around 13.5% of the down-regulated genes were biofilm-associated genes. The mapping of the biofilm-associated pathways has shown an ultimate decrease in the expression levels of the D-GMP signaling pathway and diguanylate cyclases (DGCs) genes responsible for c-di-GMP formation.

Conclusion

We predominantly report the lowering of c-di-GMP through the down-regulation of DGC genes as the main mechanism of biofilm inhibition by Trigona honey.

Antibacterial Activity of Honey Samples from Ukraine

The employment of natural substances such as beehive products with a preventive and therapeutic purpose has been a widespread custom since ancient times. In this investigation, the antibacterial activity of 41 honey samples from different Ukraine regions has been evaluated. For each honey, melissopalynological and physico-chemical analysis were performed in order to determine botanical origin, pH, glucose and fructose contents and free acidity. So, antibacterial activity against Staphylococcusaureus CCM 4223, Listeria monocytogenes ATCC 7644, Salmonella enterica serovar Typhimurium CCM 3807 and Escherichia coli ATCC 25922 was assessed through the determination of MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) values by the microdilutions method. The results show that the most susceptible bacterial strain was L. monocytogenes. Its growth was inhibited at a honey concentration ranging from 0.094 to 0.188 g/mL. The most resistant bacterial strain was S. aureus. As concerns MBC values, L. monocytogenes was the most susceptible bacteria, while S. aureus was the most resistant. Helianthus spp. honeys was the most effective against all tested bacterial strains, followed by Robinia spp. and multifloral honeys. Promising results for MIC tests have been found for Brassica spp.

Evaluation of Egyptian honeys and their floral origins: phenolic compounds, antioxidant activities, and antimicrobial characteristics

This study reports the physicochemical characterization of clover (Trifolium hybridum) and citrus (Citrus sinensis) honeys produced in Fayoum, Egypt, by evaluating the analysis of moisture content, pH, total soluble solids (TSS), electric conductivity (EC), total sugars, crude protein, ash content, total acidity, hydroxymethylfurfural (HMF), and total phenolic compounds (TPC). Antioxidant and antimicrobial activities of honey extracts and their flower extracts were determined. The results clearly indicated that ethanol gave the highest extraction yield of both clover and citrus flowers, while ethyl acetate showed the highest extraction recovery for the phenolic compounds, with TPC amounting to 338.5 and 536.4 mg gallic acid equivalent kg^-1 fresh weight in clover and citrus flower extracts, respectively. Honey samples have less TPC than their flowers. The results showed that the TPC of citrus honey and its flowers was higher than clover honey and its flowers, respectively. Antioxidant activity was higher in extracts obtained from citrus flower than extracts of clover flower. The same trend was noticed for honey samples. Both clover and citrus honeys showed antimicrobial effects against tested microorganisms. HPLC analysis showed that p-coumaric acid was the main phenolic component in ethanol extracts of clover and citrus honeys, contributing about 83.0% and 52.2%, respectively. In citrus and clover flower extracts, syringic acid and quercetin were the main phenolics, respectively. It would be expected that characteristics of honey samples are mainly depended on the floral origin of nectar foraged by bees.

Efficacy of Honey-based Ophthalmic Formulation in Patients with Corneal Ulcer: A Randomized Clinical Trial

AIM

The aim of this study was to evaluate the efficacy of honey-based ophthalmic drop in patients with foreign body induced corneal ulcer.

BACKGROUND

Honey is traditionally used for skin, mucosal and corneal ulcers. Its use is well studied in human skin and mucosal ulcers and animal model of corneal ulcer with promising effects.

METHODS

In this randomized clinical trial, 50 patients with foreign body induced corneal ulcer were allocated to receive 70% sterile honey-based ophthalmic formulation or 0.3% ophthalmic ciprofloxacin, as the standard treatment every 6 hours. All the patients were examined for the size of corneal epithelial defect, corneal infiltration and depth and followed on a daily basis until complete healing. Duration for complete healing was considered as the outcome measure. Smear, culture, antibiogram and minimum inhibition concentration (MIC) tests were performed for honey and ciprofloxacin in all patients.

RESULTS

The average durations of complete healing of corneal epithelial defect in the honey and ciprofloxacin groups were 3.88 ± 3.44 vs. 6.32 ± 3.69days, respectively (p=0.020). No significant difference was observed between two groups regarding an average duration of healing of corneal infiltration (8.12 ±1.94 days vs. 8.64±2.15 days, p=0.375). MIC of honey for pseudomonas aeruginosa was 60%w/w, for E.Coli 40% w/w, and for staphylococcus aureus 30% w/w.

CONCLUSION

Honey based ophthalmic drop can acceleratethe corneal epithelial defect healing in patients with foreign body induced corneal ulcer, compared to ophthalmic ciprofloxacin as a standard treatment. The study was registered in Iranian registry of clinical trial center (IRCT) with registration number IRCT2015020120892N1.

In vitro antimicrobial activities of Saudi honeys originating from Ziziphus spina-christi L. and Acacia gerrardii Benth. trees

Honeys originating from Sidr (Ziziphus spina-christi L.) and Talh (Acacia gerrardii Benth.) trees in Saudi Arabia exhibited substantial antimicrobial activity against pathogenic gram-positive bacteria (Bacillus cereus, Staphylococcus aureus), gram-negative bacteria (Escherichia coli, Salmonella enteritidis), and a dermatophytic fungus (Trichophyton mentagrophytes). The diameter of zones of inhibition represents the level of antimicrobial potency of the honey samples. Precisely, Talh honey showed significantly higher antibacterial activity against all tested bacteria than Sidr honey. The antifungal activity of Talh and Sidr honey types was significantly at par against a dermatophytic fungus. The water-diluted honey types (33% w/v) significantly induced a rise in the antimicrobial activity from that of the natural nondiluted honeys. Microbial strains displayed differential sensitivity; gram-positive bacteria were more sensitive and presented larger inhibition zones than gram-negative bacteria and the fungus. The sensitivity was highest in B. cereus and S. aureus, followed by T. mentagrophytes, E. coli, and S. enteritidis. The antimicrobial activity of water-diluted honeys (Sidr and Talh) was high than that of broad-spectrum antibacterial antibiotics (tetracycline and chloramphenicol) against bacterial strains, but these honeys were relativity less potent than antifungal antibiotics (flucoral and mycosat) against a fungal strain. Our findings indicate the antimicrobial potential of Saudi honeys to be considered in honey standards, and their therapeutic use as medical-grade honeys needs further investigations.

Antibacterial activity of varying UMF-graded Manuka honeys

Honey has been used as a traditional remedy for skin and soft tissue infections due to its ability to promote wound healing. Manuka honey is recognized for its unusually abundant content of the antibacterial compound, methylglyoxal (MGO). The Unique Manuka Factor (UMF) grading system reflects the MGO concentration in Manuka honey sold commercially. Our objective was to observe if UMF values correlated with the antibacterial activity of Manuka honey against a variety of pathogens purchased over the counter. The antibacterial effect of Manuka honey with UMF values of 5+, 10+, and 15+ from the same manufacturer was assessed by the broth microdilution method. Minimum inhibitory concentration (MIC) values were determined against 128 isolates from wound cultures representing gram-positive, gram-negative, drug-susceptible, and multi-drug resistant (MDR) organisms. Lower MICs were observed with UMF 5+ honey for staphylococci (n = 73, including 25 methicillin-resistant S. aureus) and Pseudomonas aeruginosa (n = 22, including 10 MDR) compared to UMF 10+ honey (p<0.05) and with UMF 10+ compared to UMF 15+ (p = 0.01). For Enterobacteriaceae (n = 33, including 14 MDR), MIC values were significantly lower for UMF 5+ or UMF 10+ compared to UMF 15+ honey (p<0.01). MIC₅₀ for UMF 5+, UMF 10+, and UMF 15+ honey against staphylococci was 6%, 7%, and 15%, and for Enterobacteriaceae was 21%, 21%, and 27%, respectively. For Pseudomonas aeruginosa MIC₅₀ was 21% and MIC₉₀ was 21–27% for all UMFs. Manuka honey exhibited antimicrobial activity against a spectrum of organisms including those with multi-drug resistance, with more potent activity overall against gram-positive than gram-negative bacteria. Manuka honey with lower UMF values, in our limited sampling, paradoxically demonstrated increased antimicrobial activity among the limited samples tested, presumably due to changes in MGO content of honey over time. The UMF value by itself may not be a reliable indicator of antibacterial effect.

Antibacterial potential of some Saudi honeys from Asir region against selected pathogenic bacteria

Honey is a nutrient rich natural product and has been utilized as traditional and complementary medicine since ancient times. In this study, antibacterial activity of Sider (Ziziphus spina-christi), Dharm (Lavandula dentata), and Majra (Hypoestes forskaolii) honey samples collected from Asir region of Saudi Arabia was in vitro evaluated at 80% and 50% w/v concentrations against five pathogenic bacteria i.e. Escherichia coli, Proteus mirabilis, Staphylococcus aureus, Shigella flexneri, and Staphylococcus epidermidis. Well diffusion assays to measure the average zone of inhibition (ZOI) and minimum inhibitory concentration (MIC) values were employed in the experiments. All the tested honey samples showed antibacterial activity in a dose-dependent manner. Sider and Dharm exhibited a good antibacterial activity at high concentrations while, Majra honey of Apis mellifera jemenitica and of Apis florea showed comparatively low antibacterial activity. The average MIC values of Sider, Dhram from Rijal Alma, Dharm from Al-Souda, Majra (A.m. jemenitica), and Majra (A. florea) honey against all tested bacteria were 22%, 16%, 18%, 32%, and 28% (v/v) respectively. Dharm and Sider honeys showed better antibacterial activity than Majra honey. Saudi honey can be considered as a promising future antimicrobial agent and should be further investigated as an alternative candidate in the management of resistant bacterial pathogens.

Honey Bee as Alternative Medicine to Treat Eleven Multidrug-Resistant Bacteria Causing Urinary Tract Infection during Pregnancy

Medicinal benefits of honey bee have been recognized in the medical community since ancient times as a remedy for many diseases and infections. This study aimed to investigate the in vitro susceptibility of 11 multidrug-resistant bacterial strains, isolated from urinary tract infections of pregnant women, to six honey samples collected from different localities in the east of Algeria. The evaluation of the antibacterial activity was performed by the well method followed by the broth dilution method using two-fold dilutions of each honey sample ranging from 2.5 to 80% (w/v). The results obtained in this study revealed that all tested honeys exhibited potent antibacterial activity against the tested strains. The diameters of inhibition ranged from 19.67 to 53.33 mm, with minimum inhibitory concentrations (MICs) ranging from 2.5 to 40% (w/v) and minimum bactericidal concentration (MBCs) varied between 2.5 and 80% (w/v). Gram-positive bacteria were found to be more susceptible than Gram-negative bacteria with diameters ranging from 43.33 to 53.33 mm; MIC and MBC values ranged from 2.5 to 5% (w/v). The P.aeruginosa strain was found to be less susceptible than other strains with inhibitory diameters ranging from 19.67 to 27.33 mm; MICs ranged from 20 to 40% and MBCs ranged from 20 to 80% (w/v). This contribution has provided a broad overview of the antibacterial activity of Algerian honey and shown that honey bee has great potential for therapeutic use as an alternative therapy for urinary tract infection treatment which is safe and efficient during pregnancy.

Mad honey: uses, intoxicating/poisoning effects, diagnosis, and treatment

Honey has been used as a folk medicine since 2100 BC; however, mad honey is different from normal natural or commercially available honey as it is contaminated with grayanotoxins, which leads to intoxication/poisoning upon consumption. Grayanotoxin is generally found in Rhododendron genus (family: Ericaceae) and is extracted by bees from nectar and pollens of flowers. Mad honey has been commonly used as an aphrodisiac (sexual stimulant), in alternative therapy for gastrointestinal disorders (peptic ulcer disease, dyspepsia, and gastritis), and for hypertension for a long time. Grayanotoxin acts on sodium ion channels and muscarinic receptors, leading to cardiac disorders (hypotension and different rhythm disorders including bradycardia, bradydysrhythmias, atrial fibrillation, nodal rhythm, atrioventricular block, and complete atrioventricular block) and respiratory depression. Patients may also exhibit any one symptom out of or combination of dizziness, blurred vision, diplopia, nausea, vomiting, vertigo, headache, sweating/excessive perspiration, extremity paresthesia, impaired consciousness, convulsion, hypersalivation, ataxia, inability to stand, and general weakness. Mad honey intoxication is diagnosed with honey intake history before the appearance of the signs and symptoms (clinical presentation), and the treatment is symptomatic. Prompt treatment includes intravenous infusions of atropine sulfate and fluids (saline infusions or simultaneous infusion of saline with atropine sulfate) if the patient presents bradycardia and severe hypotension. In case of a complete atrioventricular block, a temporary pacemaker is employed. Except for a single case from Lanping County (Southwest China), the prognosis for mad honey intoxication is very good, and no fatalities have been reported in modern medical literature excluding a few in the 1800s. Although fatalities are very rare, mad honey ingestion may still lead to arrhythmias, which can be life-threatening and hard to recognize. This article provides a brief introduction to honey, mad honey and its uses, the effects of mad honey intoxication/poisoning, and its diagnosis, prognosis, and treatment.

Honey has been used as a folk medicine since 2100 BC; however, mad honey is different from normal natural or commercially available honey as it is contaminated with grayanotoxins, which leads to intoxication/poisoning upon consumption.

Drugs - Do we need them? Applications of non-pharmaceutical therapy in anterior eye disease: A review

Natural products have been in use long before the introduction of modern drug therapies and are still used in various communities worldwide for the treatment of anterior eye disease. The aim of this review is to look at the current non-pharmaceutical modalities that have been tried and assess the body of existing evidence behind them. This includes alternative medicine, existing non-pharmaceutical therapy and more recent low and high tech solutions. A detailed search of all available databases including MEDLINE, Pubmed and Google was made to look for English-language studies for complementary and alternative treatment modalities (CAM), natural therapies and new modalities for anterior eye disease such as blepharitis, dry eye and microbial keratitis. We have included a broad discussion ranging from traditional treatments like honey and aloe vera which have been used for centuries, to the more recent technological advances like Intense Pulsed Light (IPL), LipiFlow and photoactivated chromophore for corneal cross linking in infectious keratitis (PACK-CXL). Alternative management strategies may have a role in anterior eye diseases and have a potential in changing the way we currently approach them. Some of the available CAM could play a role if incorporated in to current management practices of not only chronic diseases like blepharitis and dry eye, but also acute conditions with significant morbidity like microbial keratitis. Further large-scale randomized control trials stratified by disease severity are required to improve our understanding and to evaluate the use of non-pharmaceutical therapy against current practice.

Effect of United States buckwheat honey on antibiotic-resistant hospital acquired pathogens

INTRODUCTION

Due to an upsurge in antibiotic-resistant infections and lack of therapeutic options, new approaches are needed for treatment. Honey may be one such potential therapeutic option. We investigated the susceptibility of hospital acquired pathogens to four honeys from Wisconsin, United States, and then determined if the antibacterial effect of each honey against these pathogens is primarily due to the high sugar content.

METHODS

Thirteen pathogens including: four Clostridium difficile, two Methicillin-resistant Staphylococcus aureus, two Pseudomonas aeruginosa, one Methicillin-Susceptible Staphylococcus aureus, two Vancomycin-resistance Enterococcus, one Enterococcus faecalis and one Klebsiella pneumoniae were exposed to 1-50% (w/v) four Wisconsin honeys and Artificial honey to determine their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) using the broth dilution method.

RESULTS

Buckwheat honey predominantly exhibited a bactericidal mode of action against the tested pathogens, and this varied with each pathogen. C. difficile isolates were more sensitive to the Wisconsin buckwheat honey as compared to the other pathogens. Artificial honey at 50% (w/v) failed to kill any of the pathogens. The high sugar content of Wisconsin buckwheat honey is not the only factor responsible for its bactericidal activity.

CONCLUSION

Wisconsin buckwheat honey has the potential to be an important addition to therapeutic armamentarium against resistant pathogens and should be investigated further.