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The Efficacy of Topical Manuka Honey and Combination Antibiotic Therapy in the Treatment of MRSA Skin Infections

3 December 2013


Background: Infectious diseases continue to impact human health and life expectancy. Currently, there are numerous methicillin-resistant Staphylococcus aureus (MRSA) strains with multiple antibiotic resistance which presents a major concern to human health. Thus, treatment is becoming increasingly difficult as so many bacterial organisms present resistance to current antibiotics. Combination therapy has been used to limit the emergence of antibiotic resistant strains. Manuka honey is a unique honey produced in New Zealand. It has demonstrated inhibition of growth in vitro including S. aureus and Pseudomonas aeruginosa, two bacteria common in skin wound infections. The combined use of manuka honey and antibiotics ought to limit further emergence of antibiotic resistance. What is the efficacy of the combination of manuka honey and antibiotic therapy in treatment of MRSA skin infections?

Methods: A comprehensive search of available medical literature was conducted using Medline-OVID, PubMed, and Web of Science using the keywords: manuka honey and MRSA. The search was then narrowed to include only English language articles. The bibliographies of the articles were further searched for relevant sources. Articles with primary data evaluating the efficacy of manuka honey’s impact in topical treatment of MRSA skin infections along with combination antibiotic therapy were included.

Results: The initial result of the search yielded 29 articles for review. After screening articles for relevance, a total of three articles met inclusion criteria. These articles include three in vitro studies analyzing the synergy of manuka honey and specific antibiotics in treatment of bacterial skin infections. All studies demonstrated a synergistic effect between manuka honey and various antibiotics against MRSA skin infections.

Conclusion: The use of antibiotics and manuka honey has demonstrated in vitro to eradicate varieties of MRSA strains. Combination therapy has been proven to limit the emergence of antibiotic resistance during therapy, increase synergism and efficacy of treatment, and reduce the amount of each antibiotic used. Manuka honey is a viable adjunct to modern medicinal treatment of wound pathogens which will reduce treatment costs and limit side effects. Controlled clinical studies are needed to investigate the synergism between manuka honey and antibiotics in vivo before potential introduction as a standard of care.


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