As resistance to antibiotics strengthens, it is more important than ever to look for alternative treatments. When it comes to wound care and infection control, mānuka honey is proving to be a strong contender.

It seems hard to believe that something we spread on our toast also occupies an important place in the medicine cabinet, but research and clinical trials suggest that honey is every bit as useful now for treating wounds and fighting infection as it was in ancient times.

History lesson

Much of medicinal history relates to treating battle injuries. In Mesopotamia (2100 bc), after cleaning a wound with beer, a bandage with wine and turpentine was applied. In Ancient Egypt, after irrigating a wound with wine, physicians would then cover the wound with fat and honey. In Ancient Greece, wounds were covered and treated with herbs; infected wounds were healed with scrapings from bronze spears. Four hundred years later, Hippocrates taught that wounds should be washed with wine, bandaged, and then saturated with more wine. Vinegar, boiling oil, egg yolk, and turpentine also made it into the annals of medicine, as time and knowledge progressed.

Not all ancient natural remedies have retained a place in modern medicine. However, honey appears to be a notable exception.

Mānuka honey – a national treasure

Not all honeys were created equal, however. Leptospermum spp. honeys, known as mānuka honey in New Zealand, is one type that is lauded the world over for its medicinal properties.

All honeys, to some degree, have antibacterial properties due to their high sugar content and lower water content. They produce hydrogen peroxide when diluted, making them antibacterial. But most are very unstable, are typically affected by heat and light, and are only activated by water.

Cliff Van Eaton’s new book Mānuka, the biography of an extraordinary honey recounts the story of how research led by scientist Peter Molan in 1980 at the University of Waikato, resulted in an important discovery about what set mānuka apart from other honeys.

Molan was supervising a small experiment carried out by a high school teacher in his lab, testing some local honeys against bacteria. One of the samples yielded a confusing result, prompting Molan to investigate further. He had read that some honeys exhibited non-peroxide activities, so he set up an experiment with blackberry, clover, and mānuka honeys in which the hydrogen peroxide was knocked out. While the blackberry and clover honeys had no effect, the mānuka honey proved to be very effective against the bacteria.

The subsequent research showed that some strains of mānuka honey have a powerful, naturally-present, unique antibacterial activity not found in any other variety of honey due to its non-peroxide activity. It is also more stable, proving to be resistant to heat and light. But due to the variations within mānuka honeys, the Unique Mānuka Factor (UMF) rating was established to help identify those that contained these particular attributes.

The rise of medical-grade honeys

Van Eaton’s book describes the amazing experience of Aaron Phipps in 1999, whose extensive wounds resulting from meningococcal septicaemia completely healed within nine weeks with the help of mānuka honey – after nine months of trying more conventional treatments. Phipps’ story, and others’, helped support earlier arguments for mānuka honey to be used in a medicinal context. As the clinical research started to stack up, it became clear that this medicinal honey was not to be overlooked.

The UMF rating and antibacterial properties are not alone sufficient to classify mānuka honey as a medical-grade honey. When collecting honey, like any natural product, there is the likelihood of minor contaminants entering the product. While our stomachs can easily digest these, it is necessary to remove the bacteria completely from a honey product that is to be used in the treatment of wounds. Therefore, honey used for this purpose is collected in a vastly different manner, ensuring it is cleaned and sterilised by gamma irradiation, which does not affect its antibacterial properties.

Medical-grade honeys are making their mark all over the world, and perhaps the best known example emerges from New Zealand: Comvita’s Medihoney brand, which incorporates a range of first-aid and skincare products that are now used in hospitals and clinics around the worldand are challenging the reliance on synthetic medicines and treatments. It is one of the first medically certified honeys licensed as a medical product for professional wound care in Europe and Australia.

The Medihoney brand has withstood the rigour of clinical trials, with its first trials started under its Australian ownership and subsequent trials undertaken since Comvita took on the brand. Comvita provides a reference list that currently includes 129 articles or posters published in scientific or medical journals that reference Medihoney.

Heidi Darcy, a clinical advisor at Comvita, says there has been a big growth in the medical-grade honey market. She agrees that the growing resistance to antibiotics has the world looking for alternative treatments, and medical-grade honey can provide answers.

“Even over thousands of years, bacteria still hasn’t been able to develop resistance to mānuka honey,” she says.

Fighting MRSA

A similar argument for honey over antibiotics is emerging around its use as a treatment for the superbug MRSA (methicillin-resistant Staphylococcus aureus). Eradication of MRSA from colonised wounds following topical application of mānuka honey has been reported in patients with leg ulcers, and new research shows it could have a place in eliminating nasal MRSA as well.

New Zealand infection control specialist and peri-operative nurse Elsie Truter, a lecturer at Rotorua’s Waiariki Technical Institute, says it is only a matter of time before resistance develops to the antibiotic currently used to eliminate nasal MRSA.

“We are working with an ever-shrinking arsenal of antibiotics that can be used to treat infections. If we could develop new products that still have bactericidal ability that would be really good. Hopefully, mānuka honey will do it. It is showing some interesting results.”

Some scientists claim that significant advantages can be found from combining mānuka honey with other formulations.

Mānuka honey expert Dr Lynne Chepulis, also of Waiariki Institute of Technology, says combining mānuka honey with CycloPower™ has been shown in the lab to be even more effective in inhibiting the growth of MRSA.

The mānuka honey with CycloPower™ nasal cream product was developed by New Zealand biotechnology company Mānuka Health, which commissioned The University of Auckland to conduct this research. It is soon to be clinically trialled.

Very seldom do natural products make such an impact in the world of modern medicine. What is exciting, from an economic perspective, is that the potential for medical-grade honey is huge. The worldwide market for products to treat advanced wounds is over US$5 billion per year and growing annually by 10%. As we start to comprehend the realities of a post-antibiotic age, longer life expectancy and increasing diabetes rates, we are bound to see mānuka honey products taking ever-increasing bites out of this market.

Exisle Publishing is pleased to offer INsite readers 15% off the newly published book Manuka, the biography of an extraordinary honey by Cliff Van Eaton, which normally retails for $34.99.

Please contact editor@insitemagazine.co.nz for details.

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