We're going on four years since the World Health Organization declared antibiotic resistance a global crisis. Although the effort to reduce the use of antibiotics both in medicine and agriculture continues, these measures won't stop the oncoming post-antibiotic era. We need to find alternatives to these life-saving drugs to ensure medicine continues to be effective in keeping us safe from infection.
Several different types of antibiotic alternatives are being investigated. Some of the more promising contenders include bacterial viruses, known as bacteriophages, and molecules known as antimicrobial peptides. These options are in various stages of development and testing, and may offer some hope moving forward.
Then there are natural substances known to have antimicrobial properties. Only a few have made the grade when compared to antibiotics, but one continues to show promise. It's honey.
This natural sweetener has been used to fight infections for millennia, although in modern times it has been moved to the sidelines due to more modern treatments. Now, thanks to antibiotic resistance, there is a resurgence of interest and attention.
Back in ancient times, honey was recognized as a medicine simply because it worked to help wounds heal. But over the centuries, we have gained a much better understanding as to why this liquid is so effective at preventing bacterial growth. A combination of factors ranging from high sugar concentrations to the presence of bacteria-killing chemicals such as hydrogen peroxide make its presence incredibly troublesome for bacteria. Many microbes, including those known to cause infection, simply cannot survive in this environment.
About a decade ago, researchers decided to test honey against antibiotic-resistant bacteria. The tests in the lab confirmed the claims of the Ancients. The only new finding was that the honey was much slower than an antibiotic in killing. Yet in light of the rise of resistance, the potential benefit was considered to be worth further examination.
Eventually clinical trials were run in the hopes of gaining acceptance in the general medical community. The results revealed honey could help fight wound infections, although the outcomes revealed honey may be equal to antibiotics rather than superior to them. Still, this was considered to be positive. After all, replacing honey for antibiotics could help preserve them over time.
With this in mind, a group of Irish researchers decided to find out if they could use honey to help patients deal with one of the most troubling antibiotic resistant bacterial species, Methicillin Resistant Staphylococcus aureus, better known as MRSA. But the team didn't want to focus on the skin. Their goal was to reduce the presence of the bacterium in another common area: the nose. They knew going in the limitations of honey but hoped they could find another use for the sweet liquid.
Although honey is not perfect yet, we can't just let it sit on the shelf any longer.
They conducted a clinical trial to ensure their results would be accepted widely, though the process was relatively straightforward. When patients arrived at a hospital, they were checked for the presence of MRSA in the nose. Those who were positive for the bacterium were then asked to put one of two creams in their noses three times a day over five days. One contained honey; the other had an antibiotic.
After the trial was over, samples were collected from the patients to find out if MRSA had been eliminated. As expected, neither the honey nor the antibiotic was perfect. Only about half of the patients were considered clear of the pathogen.
While this may not seem to be a very good result from a medicinal perspective, in this trial, total clearance wasn't the goal. The authors wanted to find out if honey was comparable to the antibiotic. The results proved this to be the case, giving honey more credibility as a weapon in our battle against antibiotic resistance.
For the authors, this outcome offers hope in our battle against antibiotic resistance. If honey can be used in low-risk scenarios such as MRSA colonization of the nose, antibiotics can be saved for other more pressing infections. Yet before this can happen, more work needs to be done to find the right concentration and dosage of honey to ensure effectiveness.
This study also reveals the desperation we face with respect to antibiotic resistance. In earlier days, the results of this trial would have led to the dismissal of honey as a possible treatment. Yet, the looming post-antibiotic era demands we focus on using any means possible to prevent unnecessary use of these life-saving drugs. Although honey is not perfect yet, we can't just let it sit on the shelf any longer.
While researchers continue their efforts, we too can help reduce antibiotic resistance. We can take actions such as purchasing meat from animals raised without the use of antibiotics, not asking a physician for an antibiotic during a visit or simply improving hygiene to reduce the chances for infection.
Every time we reduce antibiotic use, we are giving public health officials a little more time to deal with the crisis. We still may lose the ability to use antibiotics in the future but hopefully, we'll find an effective alternative before it's too late.