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Honey Combination Therapies for Skin and Wound Infections: A Systematic Review of the Literature

Authors McLoone P, Tabys D, Fyfe L

Received 15 September 2020

Accepted for publication 10 October 2020

Published 24 November 2020 Volume 2020:13 Pages 875—888


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Jeffrey Weinberg

Pauline McLoone,1 Dina Tabys,1 Lorna Fyfe2

1Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan; 2Dietetics, Nutrition, and Biological Sciences, Queen Margaret University, Musselburgh, East Lothian EH21 6UU, UK

Correspondence: Pauline McLoone
Department of Biomedical Sciences, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan
Tel +7-775-365-14-72

Abstract: Topical application of medical grade honey is recommended for the clinical management of wound infections. The suitability of honey as a wound healing agent is largely due to its antibacterial activity, immune modulatory properties, and biocompatibility. Despite the usefulness of honey in wound healing, chronic wound infections continue to be a global problem requiring new and improved therapeutic interventions. Several recent studies have investigated the effects of combining honey with other therapies or agents with the aim of finding more efficacious treatments. In this systematic review, the database PubMed was used to carry out a search of the scientific literature on the combined effects of honey and other therapies on antimicrobial activity and wound and skin healing. The search revealed that synergistic or additive antimicrobial effects were observed in vitro when honey was combined with antibiotics, bacteriophages, antimicrobial peptides, natural agents, eg, ginger or propolis and other treatment approaches such as the use of chitosan hydrogel. Outcomes depended on the type of honey, the combining agent or treatment and the microbial species or strain. Improved wound healing was also observed in vivo in mice when honey was combined with laser therapy or bacteriophage therapy. More clinical studies in humans are required to fully understand the effectiveness of honey combination therapies for the treatment of skin and wound infections.

Keywords: honey, antibiotics, natural agents, combination therapy, wound infection, skin infection

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