This article is more than 5 years old. Information may no longer be current.
Honey ineffective in preventing peritoneal dialysis-related infections
Click Here to Manage Email Alerts
Honey did not prevent infections related to peritoneal dialysis any better than mupirocin, according to recent data published in The Lancet Infectious Diseases.
“Our study demonstrated that antibacterial honey was not more effective at preventing peritoneal dialysis-related infections than the standard mupirocin therapy, and was possibly inferior in patients with diabetes,” David Johnson, MD, of the University of Queensland in Brisbane, Australia, told Infectious Disease News. “This finding, combined with the observed high rates of study withdrawal and local skin reactions in the honey group led us to conclude that honey cannot be routinely recommended as an infection control strategy in peritoneal dialysis patients.”
David Johnson
According to Johnson, honey has shown antimicrobial action against a broad spectrum of fungi and bacteria, and it has the added benefit of not inducing antibiotic resistance. Johnson’s previous research demonstrated that topical application of antibacterial honey to exit sites of hemodialysis catheters in patients with end-stage renal disease was as safe and effective as mupirocin. This led to the current study of its effect in peritoneal dialysis.
The open-label trial, which was coordinated by the Australasian Kidney Trials Network, included 371 participants who were randomly assigned in a 1:1 ratio to topical exit-site application with antibacterial honey plus standard exit-site care or intranasal mupirocin prophylaxis plus standard exit-site care. Participants were recruited from Sept. 17, 2008, to June 17, 2011, and the primary endpoint was time to first infection related to dialysis.
Among those who received honey, the median infection-free survival time was 16 months, and not significantly different from that of the control group time of 17.7 months (HR=1.12; 95% CI, 0.83-1.51). Among patients with diabetes who received the honey, there was a significantly higher risk of the primary endpoint (HR=1.85; 95% CI, 1.05-3.24) and a higher risk for peritonitis (HR=2.25; 95% CI, 1.16-4.36). Among participants without diabetes, there was no difference in the primary endpoint between the groups, but the risk for peritonitis was lower in the honey group (HR=0.62; 95% CI, 0.38-1.0).
“Future studies of interventions to prevent peritoneal dialysis–associated infections, should consider a head-to-head comparison of nasal vs. exit-site application of mupirocin or newer topical antibacterial cream versus topical mupirocin,” Johnson said. “We also suggest randomization to include stratification for diabetes.”
Disclosure: The researchers report financial relationships with Baxter Healthcare, Fresenius Medical Care and Gambro.
Click Here to Manage Email Alerts