Honey’s ‘trick’ to treat infections: myth or reality?

In 1945 Alexander Fleming, Howard Florey and Ernst Chain received the Nobel Prize in Medicine for the discovery of penicillin, the first broad-spectrum antibiotic in history. Shortly after the discovery, they realized and warned of the ease with which bacteria could develop tolerance to this new remedy if used improperly.

Seventy-six years later, bacterial resistance to antibiotics has become a challenge to humanity. Currently, there are bacteria that are able to resist almost all or even all therapeutic options approved for treatment. As a result, some common infections have become very difficult or even impossible to treat.

Faced with this situation, the scientific community is studying substances, formulations or active principles used before the era of antibiotics. Honey is one of them. Not in vain, the Egyptians, Greeks and Romans used honey not only as food, but also for therapeutic purposes. But what secrets does this sweet and sticky substance hide?

Honey against bacteria

Honey has particular characteristics and a variety of substances that have been suggested as key elements responsible for its antimicrobial potential. On the one hand, the high sugar content (mainly glucose and fructose, although also other minor sugars), combined with low water content, make honey an unfavorable environment for the growth and multiplication of bacteria.

But nevertheless, various studies have shown that an “artificial honey” (prepared with a mixture of sugars at concentrations similar to those found in honey) it is not as effective in inhibiting the growth of bacteria. Therefore, there must be other factors that justify their activity.

Honey is an acidic food. In its composition they have been identified more than 32 different organic acids (gluconic, acetic, citric, formic, malic, oxalic …) that also create unfavorable conditions for microbial growth.

On the other hand, it also has other minor compounds with antibacterial properties. Among them are phenolic compounds, methylglyoxal (characteristic of manuka honey, although it is also present in other varieties to a lesser extent), defensin-1 peptide or hydrogen peroxide.

Yes, hydrogen peroxide, you read that correctly: honey that has not been subjected to heat treatments contains an enzyme (glucose oxidase) that is incorporated by bees when they are preparing this delicious delicacy. This enzyme is activated with a moderate dilution of honey and reacts with glucose, producing gluconic acid and hydrogen peroxide (more commonly known as hydrogen peroxide).

Hundreds of compounds

Honey has shown, in numerous studies in vitro, be effective against different pathogenic bacteria. Even some that were already resistant to antibiotics.

On the other hand, it has also proved than in combined treatments with antibiotics honey allows to reduce the doses of these and is capable of reverse resistors previously acquired from them.

But how does honey get all this? As we have said, it is a very complex substance that contains hundreds of compounds that cause specific effects, different and simultaneous on various structures or functions of microorganisms.

The honey fight

In terms of understanding the mechanisms of action of honey on bacteria, most of the research has been done using manuka honey. This is one of the most studied varieties in the world and one of the few that have commercial medical grade options. However, more and more studies are being carried out with other different varieties.

It has been proved that honey causes changes in the morphology and structure of bacteria, even breaking them. All of this puts your survival. On the other hand, honey also affects what is known as the bacterial membrane potential, a system of exchange of molecules that allows regulating the balance of the bacteria. bacteria and their vital functions.

Other mechanisms more recently described indicate that honey acts on the metabolism of bacteria and on some mechanisms that allow them to develop antibiotic resistance.

In short, what honey can be a potential antibacterial agent is widely demonstrated, in particular to treat infected wounds or as a preventive agent to avoid infection thereof.

However, its use in medicine has limitations mainly related to its composition and mode of application. Therefore, more studies are necessary in vivo corroborating the promising results previously obtained in vitro. Be that as it may, honey for medicinal uses it has to be safe, produced under rigorous hygiene standards and without presenting pesticides or other pollutants in its composition.

* This article was originally published in The Conversation.

** Patricia Combarros Fuertes is a doctor in Veterinary Medicine and beekeeper, University of León.

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