1
|
Bocoum A, Riel SJJMV, Traoré SO, Ngo Oum Ii EF, Traoré Y, Thera AT, Fané S, Dembele BT, Cremers NAJ. Medical-Grade Honey Enhances the Healing of Caesarean Section Wounds and Is Similarly Effective to Antibiotics Combined with Povidone-Iodine in the Prevention of Infections-A Prospective Cohort Study. Antibiotics (Basel) 2023; 12. [PMID: 36671293 DOI: 10.3390/antibiotics12010092] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Caesarean sections (CS) are becoming increasingly popular. The antibiotic resistance crisis and relentless risk of infections, especially in developing countries, demand alternative treatment options. Medical-grade honey (MGH) exerts antimicrobial and healing properties. This study aims to evaluate the effect of MGH treatment on CS wound healing and postoperative complications when compared to conventional treatment (antibiotics in combination with povidone-iodine). In this prospective cohort study, 766 CS patients were included and evenly divided into two groups. The treatment group (n = 383) received an MGH-based formulation (L-Mesitran Soft) and the control group (n = 383) received antibiotics (Amoxicillin) combined with povidone-iodine. The wound healing time and complication rate were determined for both groups, and subsequently, predisposing factors for complications among the baseline characteristics and non-patient-related parameters were determined. The baseline characteristics were similar for both study groups, supporting a homogenous distribution. Postoperative complications were experienced by 19.3% of the patients in the control group and 18.8% in the treatment (MGH) group. The treatment group experienced significantly more superficial pus discharge than the control group, while the latter experienced significantly more deeper pus discharge. BMI, age, duration of hospitalization, anesthesia, and duration of CS could affect the complication risk. MGH significantly enhanced wound healing until day 42. On average, the healing time with MGH was 19.12 ± 7.760 days versus 24.54 ± 8.168 days in the control group. MGH is a potent alternative treatment to antibiotics and povidone-iodine because while the complication risk is similar, MGH has additional benefits. MGH promotes wound healing and does not bear the risk of resistance.
Collapse
|
2
|
Naik PP, Mossialos D, van Wijk B, Novakova P, Wagener FADTG, Cremers NAJ. Medical-Grade Honey Outperforms Conventional Treatments for Healing Cold Sores-A Clinical Study. Pharmaceuticals (Basel) 2021; 14:1264. [PMID: 34959664 PMCID: PMC8706154 DOI: 10.3390/ph14121264] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 02/06/2023] Open
Abstract
Cold sores are nasolabial blisters caused by herpes simplex virus (HSV) infections. Novel therapies demonstrating simultaneously antiviral activity and improved wound healing are warranted. The aim of this study was to investigate the efficacy of medical-grade honey (MGH) for treating HSV-induced cold sores. A crossover trial was performed in patients with recurrent cold sores (n = 29). The majority (65.6%) of these patients experience four or more episodes per year, thus forming a valid self-control group. In this study, patients applied an MGH-based formulation (L-Mesitran Soft) on their cold sore at the onset of symptoms (62.1%) or appearing of blister (37.9%) and compared it to their conventional treatments. After complete healing, patients filled in a questionnaire evaluating healing, pain, and itching. The average absolute healing time was 72.4% slower with conventional treatment (10.0 days) compared to MGH (5.8 days). After MGH treatment, 86.2% of all patients experienced faster objective healing (6.9% similar and 6.9% slower) and the subjective healing score was higher in 79.3% of the patients (20.7% similar). If the patients normally experience pain and itching during their cold sores, these levels were lower with MGH therapy compared to conventional treatment in 72.7% and 71.4% of the patients, respectively. Moreover, 100% of the patients prefer MGH treatment over conventional treatment and will use it again on future cold sores. MGH is a promising alternative treatment for cold sores, likely by combining both increased antiviral and wound healing activities while alleviating pain and itching.
Collapse
Affiliation(s)
- Piyu Parth Naik
- Saudi German Hospitals and Clinics, Department of Dermatology, Hessa Street 331 West, Al Barsha 3, Exit 36 Sheikh Zayed Road, Dubai P.O. Box 391093, United Arab Emirates;
| | - Dimitris Mossialos
- Department of Biochemistry and Biotechnology, University of Thessaly, Biopolis-Mezurlo, 41500 Larisa, Greece;
| | - Bas van Wijk
- Department of Dentistry, Radboud University Medical Center, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands; (B.v.W.); (F.A.D.T.G.W.)
| | - Petra Novakova
- LERAM Pharmaceuticals s.r.o., Páteřní 1216/7, 63500 Brno, Czech Republic;
| | - Frank A. D. T. G. Wagener
- Department of Dentistry, Radboud University Medical Center, Philips van Leydenlaan 25, 6525 EX Nijmegen, The Netherlands; (B.v.W.); (F.A.D.T.G.W.)
| | | |
Collapse
|
3
|
van Riel SJJM, Lardenoije CMJG, Oudhuis GJ, Cremers NAJ. Treating (Recurrent) Vulvovaginal Candidiasis with Medical-Grade Honey-Concepts and Practical Considerations. J Fungi (Basel) 2021; 7:jof7080664. [PMID: 34436203 PMCID: PMC8400673 DOI: 10.3390/jof7080664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 01/04/2023] Open
Abstract
Recurrent vulvovaginal candidiasis (RVVC) is a relapsing vaginal fungal infection caused by Candida species. The prevalence varies among age populations and can be as high as 9%. Treatment options are limited, and in 57% of the cases, relapses occur within six months after fluconazole maintenance therapy, which is the current standard of care. The pathogenesis of RVVC is multifactorial, and recent studies have demonstrated that the vaginal microenvironment and activity of the immune system have a strong influence on the disease. Medical-grade honey (MGH) has protective, antimicrobial, and immunomodulatory activity and forms a putative alternative treatment. Clinical trials have demonstrated that honey can benefit the treatment of bacterial and Candida-mediated vaginal infections. We postulate that MGH will actively fight ongoing infections; eradicate biofilms; and modulate the vaginal microenvironment by its anti-inflammatory, antioxidative, and immunomodulatory properties, and subsequently may decrease the number of relapses when compared to fluconazole. The MGH formulation L-Mesitran Soft has stronger antimicrobial activity against various Candida species than its raw honey. In advance of a planned randomized controlled clinical trial, we present the setup of a study comparing L-Mesitran Soft with fluconazole and its practical considerations.
Collapse
Affiliation(s)
- Senna J. J. M. van Riel
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands; (S.J.J.M.v.R.); (C.M.J.G.L.)
| | - Celine M. J. G. Lardenoije
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands; (S.J.J.M.v.R.); (C.M.J.G.L.)
| | - Guy J. Oudhuis
- Department of Medical Microbiology, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6202 AZ Maastricht, The Netherlands;
| | - Niels A. J. Cremers
- Triticum Exploitatie B.V., Sleperweg 44, 6222 NK Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-43-325-1773
| |
Collapse
|
4
|
Bugarova V, Godocikova J, Bucekova M, Brodschneider R, Majtan J. Effects of the Carbohydrate Sources Nectar, Sucrose and Invert Sugar on Antibacterial Activity of Honey and Bee-Processed Syrups. Antibiotics (Basel) 2021; 10:985. [PMID: 34439035 PMCID: PMC8388957 DOI: 10.3390/antibiotics10080985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 12/27/2022] Open
Abstract
Honey is a functional food with health-promoting properties. Some types of honey are used in wound care for the treatment of acute and chronic infected wounds. Increased interest in using honey as a functional food and as a base for wound care products causes limited availability of raw honey. Numerous studies suggest that the protein content of honey is mainly comprised of bee-derived proteins and peptides, with a pronounced antibacterial effect. Therefore, the aim of our study was to characterize for the first time the antibacterial activity of raw honeys and bee-processed syrups which were made by processing sucrose solution or invert sugar syrup in bee colonies under field conditions. Furthermore, we compared the contents of glucose oxidase (GOX) and the levels of hydrogen peroxide (H2O2) in honey samples and bee-processed syrups. These parameters were also compared between the processed sucrose solution and the processed invert sugar syrup. Our results clearly show that natural honey samples possess significantly higher antibacterial activity compared to bee-processed syrups. However, no differences in GOX contents and accumulated levels of H2O2 were found between honeys and bee-processed syrups. Comparison of the same parameters between bee-processed feeds based on the two artificial carbohydrate sources revealed no differences in all measured parameters, except for the content of GOX. The amount of GOX was significantly higher in bee-processed sucrose solutions, suggesting that processor bees can secrete a higher portion of carbohydrate metabolism enzymes. Determination of honey color intensity showed that in bee colonies, bee-processed syrups were partially mixed with natural honey. Further research is needed to identify the key botanical compounds in honey responsible for the increased antibacterial potential of honey.
Collapse
Affiliation(s)
- Veronika Bugarova
- Laboratory of Apidology and Apitherapy, Department of Microbial Genetics, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska Cesta 21, 845 51 Bratislava, Slovakia; (V.B.); (J.G.); (M.B.)
| | - Jana Godocikova
- Laboratory of Apidology and Apitherapy, Department of Microbial Genetics, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska Cesta 21, 845 51 Bratislava, Slovakia; (V.B.); (J.G.); (M.B.)
| | - Marcela Bucekova
- Laboratory of Apidology and Apitherapy, Department of Microbial Genetics, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska Cesta 21, 845 51 Bratislava, Slovakia; (V.B.); (J.G.); (M.B.)
| | - Robert Brodschneider
- Institute of Biology, University of Graz, Universitätsplatz 2, A-8010 Graz, Austria;
| | - Juraj Majtan
- Laboratory of Apidology and Apitherapy, Department of Microbial Genetics, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska Cesta 21, 845 51 Bratislava, Slovakia; (V.B.); (J.G.); (M.B.)
- Department of Microbiology, Faculty of Medicine, Slovak Medical University, Limbova 12, 833 03 Bratislava, Slovakia
| |
Collapse
|
5
|
de Groot T, Janssen T, Faro D, Cremers NAJ, Chowdhary A, Meis JF. Antifungal Activity of a Medical-Grade Honey Formulation against Candida auris. J Fungi (Basel) 2021; 7:jof7010050. [PMID: 33450974 PMCID: PMC7828376 DOI: 10.3390/jof7010050] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 02/06/2023] Open
Abstract
Candida auris is a pathogenic yeast causing outbreaks in intensive care units with high mortality rates. The treatment of C. auris colonization is challenging due to high resistance rates. A potential alternative antifungal treatment is medical-grade honey. In this study the susceptibility of C. auris and other Candida species to the medical-grade honey-based formulation L-Mesitran® Soft was investigated. The medical-grade honey formulation reduced the growth of C. auris and other Candida species in a dose-dependent manner. This inhibition was not only due to the honey component, as treatment with an identical concentration of this component only was less effective and even stimulated the growth of C. albicans and C. glabrata, supporting the interpretation that supplements in the medical-grade honey formulation enhanced the antimicrobial activity. Increasing the concentration of the honey component to 40%, as is also present in an undiluted medical-grade honey formulation, lead to a 1- to 4-log inhibition of all Candida species. Unprocessed local honey reduced the growth of nearly all Candida species more strongly than medical-grade honey. C. auris' susceptibility to the medical-grade honey formulation did not depend on geographic origin or resistance profile, although the multiresistant isolates tended to be more susceptible. Altogether, medical-grade honey formulation has a strong antifungal activity against C. auris and other Candida species. Future studies should demonstrate whether the treatment of open wounds or skin colonized with C. auris is feasible and effective in the clinical setting.
Collapse
Affiliation(s)
- Theun de Groot
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
- Correspondence: ; Tel.: +31-24-365-8677
| | - Tom Janssen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
| | - Dirk Faro
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
| | | | - Anuradha Chowdhary
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110007, India;
| | - Jacques F. Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital (CWZ), 6532 SZ Nijmegen, The Netherlands; (T.J.); (D.F.); (J.F.M.)
- Centre of Expertise in Mycology Radboudumc/CWZ, 6532 SZ Nijmegen, The Netherlands
- Bioprocess Engineering and Biotechnology Graduate Program, Federal University of Paraná, Curitiba 80060-000, Brazil
| |
Collapse
|
6
|
Pleeging CCF, Coenye T, Mossialos D, de Rooster H, Chrysostomou D, Wagener FADTG, Cremers NAJ. Synergistic Antimicrobial Activity of Supplemented Medical-Grade Honey against Pseudomonas aeruginosa Biofilm Formation and Eradication. Antibiotics (Basel) 2020; 9:E866. [PMID: 33291554 DOI: 10.3390/antibiotics9120866] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 02/07/2023] Open
Abstract
Biofilms hinder wound healing. Medical-grade honey (MGH) is a promising therapy because of its broad-spectrum antimicrobial activity and the lack of risk for resistance. This study investigated the inhibitory and eradicative activity against multidrug-resistant Pseudomonas aeruginosa biofilms by different established MGH-based wound care formulations. Six different natural wound care products (Medihoney, Revamil, Mebo, Melladerm, L-Mesitran Ointment, and L-Mesitran Soft) were tested in vitro. Most of them contain MGH only, whereas some were supplemented. L-Mesitran Soft demonstrated the most potent antimicrobial activity (6.08-log inhibition and 3.18-log eradication). Other formulations ranged between 0.89-log and 4.80-log inhibition and 0.65-log and 1.66-log eradication. Therefore, the contribution of different ingredients of L-Mesitran Soft was investigated in more detail. The activity of the same batch of raw MGH (1.38-log inhibition and 2.35-log eradication), vitamins C and E (0.95-log inhibition and 0.94-log eradication), and all ingredients except MGH (1.69-log inhibition and 0.75-log eradication) clearly support a synergistic activity of components within the L-Mesitran Soft formulation. Several presented clinical cases illustrate its clinical antimicrobial efficacy against Pseudomonas aeruginosa biofilms. In conclusion, MGH is a potent treatment for Pseudomonas biofilms. L-Mesitran Soft has the strongest antimicrobial activity, which is likely due to the synergistic activity mediated by its supplements.
Collapse
|
7
|
Nolan VC, Harrison J, Wright JEE, Cox JAG. Clinical Significance of Manuka and Medical-Grade Honey for Antibiotic-Resistant Infections: A Systematic Review. Antibiotics (Basel) 2020; 9:antibiotics9110766. [PMID: 33142845 PMCID: PMC7693943 DOI: 10.3390/antibiotics9110766] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 01/22/2023] Open
Abstract
Antimicrobial resistance is an ever-increasing global issue that has the potential to overtake cancer as the leading cause of death worldwide by 2050. With the passing of the "golden age" of antibiotic discovery, identifying alternative treatments to commonly used antimicrobials is more important than ever. Honey has been used as a topical wound treatment for millennia and more recently has been formulated into a series of medical-grade honeys for use primarily for wound and burn treatment. In this systematic review, we examined the effectiveness of differing honeys as an antimicrobial treatment against a variety of multidrug-resistant (MDR) bacterial species. We analysed 16 original research articles that included a total of 18 different types of honey against 32 different bacterial species, including numerous MDR strains. We identified that Surgihoney was the most effective honey, displaying minimum inhibitory concentrations as low as 0.1% (w/v); however, all honeys reviewed showed a high efficacy against most bacterial species analysed. Importantly, the MDR status of each bacterial strain had no impact on the susceptibility of the organism to honey. Hence, the use of honey as an antimicrobial therapy should be considered as an alternative approach for the treatment of antibiotic-resistant infections.
Collapse
Affiliation(s)
- Victoria C. Nolan
- College of Health and Life Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK; (V.C.N.); (J.H.)
| | - James Harrison
- College of Health and Life Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK; (V.C.N.); (J.H.)
| | - John E. E. Wright
- Department of Intensive Care Medicine, Great Western Hospital NHS Foundation Trust, Swindon SN3 6BB, UK;
| | - Jonathan A. G. Cox
- College of Health and Life Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK; (V.C.N.); (J.H.)
- Correspondence: ; Tel.: +44-121-204-5011
| |
Collapse
|
8
|
Nair HKR, Tatavilis N, Pospíšilová I, Kučerová J, Cremers NAJ. Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series. Antibiotics (Basel) 2020; 9:antibiotics9090529. [PMID: 32825100 PMCID: PMC7558111 DOI: 10.3390/antibiotics9090529] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022] Open
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.
Collapse
Affiliation(s)
- Harikrishna K. R. Nair
- Wound Care Unit, Department of Internal Medicine, 50586, Kuala Lumpur Hospital, Kuala Lumpur 50586, Malaysia;
| | | | - Ivana Pospíšilová
- Hospital Na Pleši (Nemocnice Na Pleši s. r. o.), Complex Rehabilitation Center, 262 04 Nová Ves pod Pleší, Czech Republic;
| | - Jana Kučerová
- Hospital Na Pleši (Nemocnice Na Pleši s. r. o.), Surgical clinic, 262 04 Nová Ves pod Pleší, Czech Republic;
| | - Niels A. J. Cremers
- Triticum Exploitatie BV, 6222NK Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-(0)43-325-1773
| |
Collapse
|