Synergistic Antimicrobial Activity of Supplemented Medical-Grade Honey against <i>Pseudomonas aeruginosa</i> Biofilm Formation and Eradication

• Main Authors: Carlos C. F. Pleeging (Author), Tom Coenye (Author), Dimitris Mossialos (Author), Hilde de Rooster (Author), Daniela Chrysostomou (Author), Frank A. D. T. G. Wagener (Author), Niels A. J. Cremers (Author)
• Format: Book
• Published: MDPI AG, 2020-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antibiotics9120866; 2079-6382
• Keywords: medical-grade honey; supplements; vitamin C; vitamin E; antimicrobial; biofilm; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 9, Iss 12, p 866 (2020)

Biofilms hinder wound healing. Medical-grade honey (MGH) is a promising therapy because of its broad-spectrum antimicrobial activity and the lack of risk for resistance. This study investigated the inhibitory and eradicative activity against multidrug-resistant <i>Pseudomonas aeruginosa</i> biofilms by different established MGH-based wound care formulations. Six different natural wound care products (Medihoney, Revamil, Mebo, Melladerm, L-Mesitran Ointment, and L-Mesitran Soft) were tested in vitro. Most of them contain MGH only, whereas some were supplemented. L-Mesitran Soft demonstrated the most potent antimicrobial activity (6.08-log inhibition and 3.18-log eradication). Other formulations ranged between 0.89-log and 4.80-log inhibition and 0.65-log and 1.66-log eradication. Therefore, the contribution of different ingredients of L-Mesitran Soft was investigated in more detail. The activity of the same batch of raw MGH (1.38-log inhibition and 2.35-log eradication), vitamins C and E (0.95-log inhibition and 0.94-log eradication), and all ingredients except MGH (1.69-log inhibition and 0.75-log eradication) clearly support a synergistic activity of components within the L-Mesitran Soft formulation. Several presented clinical cases illustrate its clinical antimicrobial efficacy against <i>Pseudomonas aeruginosa</i> biofilms. In conclusion, MGH is a potent treatment for <i>Pseudomonas</i> biofilms. L-Mesitran Soft has the strongest antimicrobial activity, which is likely due to the synergistic activity mediated by its supplements.