Inhalation therapy containing manuka honey, amikacin shows promise for respiratory infections

Combining manuka honey and the antibiotic amikacin in a lab-based nebulization formulation was effective for inhibiting Mycobacterium abscessus and drug-resistant clinical isolates in patients with cystic fibrosis or bronchiectasis.

“So far, treatment of Mycobacterium abscessus pulmonary infections can be problematic due to its drug-resistant nature. The variety of antibiotics required to combat infection result in severe side effects,” Victoria C. Nolan, MRes, PhD researcher at Aston University in Birmingham, U.K., said in a related press release. “However, the use of this potential treatment combining amikacin and manuka honey shows great promise as an improved therapy for these terrible pulmonary infections.”

Previous research has demonstrated manuka honey has a broad spectrum of antimicrobial activity, according to the release.

Researchers collected samples of M. abscessus, which usually affects patients with cystic fibrosis or bronchiectasis, from 16 patients with cystic fibrosis and assessed manuka honey combined with amikacin (Insmed) to identify the dosage needed to kill the bacteria. Using a lab-based lung model and nebulizer, researchers nebulized manuka honey combined with amikacin.

Results, published in Microbiology, demonstrated that the highest concentration (0.476 g/mL^–1) of all four strengths of manuka honey tested inhibited M. abscessus. In addition, the highest concentration proved to be bactericidal, the researchers. Compared with no treatment with manuka honey, the next lowest manuka honey concentration (0.238 g/mL^–1) reduced bacterial growth but did not demonstrate a bactericidal effect.

In addition, the combination of nebulized manuka honey at 0.37 g/mL^–1 and amikacin at 1.6 mg/mL^–1 inhibited growth of M. abscessus. This lower dose of amikacin may result in fewer life-changing adverse events, the researchers wrote.

To evaluate antimicrobial activity, researchers screened M. abscessus samples against the four manuka honey samples and observed a variety of activity for all isolates with a minimum inhibitory concentration of 0.476 g/mL^–1 or lower, according to the results.

“The use of this inhalation therapy of amikacin and manuka honey shows great promise as an improved therapy for M. abscessus pulmonary infections, which could lead to an increase in successful treatment outcomes and reduce the burden on the patient produced by drug-associated side effects,” the researchers wrote.

Further research is warranted, according to the researchers.

“I am delighted with the outcome of this research because it paves the way for future experiments, and we hope that with funding we can move towards clinical trials that could result in a change in strategy for the treatment of this debilitating infection,” Jonathan Cox, MD, senior lecturer in microbiology at the School of Biosciences at Aston University, said in the release.

Reference:

• Manuka honey could help to clear deadly drug-resistant lung function – research. Published Aug. 9, 2022. Accessed Sept. 12, 2022.