Future Perspective
The multiple effects demonstrated by honey combined with the lack of resistance supports the idea that it could have an important role in decontaminating infected wounds in a clinical setting. Its use to successfully remove bacteria from wounds has been shown in several studies.[57,58] It is envisaged that medical-grade honey preparations might be used in the future alongside current antimicrobial wound treatments and antibiotics both prophylactically (e.g., postsurgery) or as a front-line first aid treatment. Given the strong evidence describing the synergistic action of manuka honey and systemically administered antibiotics, honey might find a place in clinical practice as part of combination antimicrobial therapies to treat multidrug-resistant bacterial wound infections. In the UK it is already on the formulary of some primary care trusts. In the future, robust, large-scale clinical trials are imperative to confirm that the in vitro observations are matched in vivo. To fully elucidate the molecular mechanisms underpinning the observed effects, further transcriptomic and proteomic studies are needed; without which it is anticipated that uptake of honey as a wound treatment will remain low.
Future Microbiol. 2013;8(11):1419-1429. © 2013 Future Medicine Ltd.
