The benefits of manuka honey have been used throughout the areas of New Zealand and Australia for many years. It has been said that manuka honey is four times more nutrient-dense in terms of its healing compounds compared to regular floral honey. Now, a team of scientists at Aston University has combined manuka honey and the drug amikacin in a lab-based nebulization formulation to treat the harmful bacterial lung infection Mycobacterium abscessus.

The findings are published in the journal Microbiology in an article entitled, “In vitro synergy between manuka honey and amikacin against Mycobacterium abscessus complex shows potential for nebulization therapy.”

M. abscessus is an opportunistic human pathogen of increasing concern, due to its ability to cause aggressive pulmonary infections (especially in cystic fibrosis patients), as well as skin and soft tissue infections,” wrote the researchers. “M. abscessus is intrinsically drug-resistant and treatment regimens are lengthy, consisting of multiple antibiotics with severe side effects and poor patient success rates. New and novel strategies are urgently required to combat these infections. One such strategy thus far overlooked for mycobacteria is manuka honey. For millennia manuka honey has been shown to have wide-ranging medicinal properties, which have more recently been identified for its broad spectrum of antimicrobial activity. Here we demonstrate that manuka honey can be used to inhibit M. abscessus and a variety of drug-resistant clinical isolates in vitro.”

In the study, the researchers used samples of the bacteria M. abscessus taken from 16 infected cystic fibrosis (CF) patients. They then tested the antibiotic amikacin, combined with manuka honey, to discover what dosage was required to kill the bacteria.

Manuka honey has antibacterial, antiviral, anti-inflammatory, and antioxidant properties. It gets its antibacterial effects from an active ingredient called methylglyoxal (MGO). MGO is created in manuka honey by the conversion of another compound known as dihydroxyacetone (DHA). A high concentration of DHA is found in the nectar of manuka flowers. The higher the concentration of MGO, the stronger the antibacterial effects of manuka honey.

M. abscessus is a bacterial pathogen from the same family that causes tuberculosis. However, this pathogen differs by causing serious lung infections in people (particularly children) with pre-existing lung conditions, such as CF and bronchiectasis, as well as causing skin and soft tissue infections.

Patients are given a cocktail of antibiotics, consisting of 12 months or more of antimicrobial chemotherapy, and which often doesn’t result in a cure. The dosage of amikacin usually used on a patient to kill the infection is 16 micrograms per milliliter. But the researchers found that the new combination using manuka honey, required a dosage of just two micrograms per milliliter of amikacin.

“So far treatment of M. abscessus pulmonary infections can be problematic due to its drug-resistant nature,” explained Victoria Nolan, lead author and PhD researcher.

The use of this inhalation therapy of amikacin and manuka honey demonstrates great promise as an improved therapy for M. abscessus pulmonary infections, which could lead to an increase in successful treatment outcomes and reduce the burden on the patient produced by drug-associated side effects.

“By combining a totally natural ingredient such as manuka honey with amikacin, one of the most important yet toxic drugs used for treating M. abscessus, we have found a way to potentially kill off these bacteria with eight times less drug than before. This has the potential to significantly reduce amikacin-associated hearing loss and greatly improve the quality of life of so many patients—particularly those with cystic fibrosis.

“I am delighted with the outcome of this research because it paves the way for future experiments and we hope that with funding we can move towards clinical trials that could result in a change in strategy for the treatment of this debilitating infection,” concluded Jonathan Cox, PhD, senior lecturer in microbiology, Aston University.

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