In vitro synergy between manuka honey and amikacin against Mycobacterium abscessus complex shows potential for nebulisation therapy


Mycobacterium abscessusis an opportunistic human pathogen of increasing concern, due to its ability to cause aggressive pulmonary infections (especially in cystic fibrosis patients), as well as skin and soft tissue infections. M. abscessus is intrinsically drug resistant and treatment regimens are lengthy, consisting of multiple antibiotics with severe side effects and poor patient success rates. New and novel strategies are urgently required to combat these infections. One such strategy thus far overlooked for mycobacteria is manuka honey. For millennia manuka honey has been shown to have wide ranging medicinal properties, which have more recently been identified for its broad spectrum of antimicrobial activity. Here we demonstrate that manuka honey can be used to inhibit M. abscessus and a variety of drug resistant clinical isolates in vitro. We also demonstrate using a microbroth dilution checkerboard assay that manuka honey works synergistically with amikacin, which is one of the current front line antibiotics used for treatment of M. abscessus infections. This was further validated using an in vitro inhalation model, where we showed that with the addition of manuka honey, the amikacin dosage can be lowered whilst increasing its efficacy. These findings demonstrate the utility of manuka honey for incorporation into nebulised antibiotic treatment for respiratory infections, in particular M. abscessus. These results pave the way for a change of strategy for M. abscessus management, offering new therapeutic options for this deadly infection.

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Divisions: College of Health & Life Sciences > School of Biosciences
College of Health & Life Sciences
Additional Information: © 2022 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution. Funding Information: J.A.G.C. is grateful to the Academy of Medical Sciences, Global Challenges Research Fund, Birmingham Women’s and Children’s Hospital Charity Research Foundation and Give A Child Health Fund for their continued support of the Mycobacterial Research Group at Aston University. This research was funded by the Academy of Medical Sciences/the British Heart Foundation/the Government Department of Business, Energy and Industrial Strategy/Global Challenges Research Fund/the Wellcome Trust Springboard Award [SBF003\1088]. VCN is supported with a PhD Studentship jointly funded by Give A Child Health Fund and Aston University. JH is supported by a Venture Innovation Award from the Cystic Fibrosis Trust, UK, VIA Award Number: 098.
Uncontrolled Keywords: Manuka honey,Mycobacterium abscessus,Synergy,Antimicrobial,Nebulised therapy,Amikacin
Publication ISSN: 1465-2080
Last Modified: 08 Dec 2023 12:05
Date Deposited: 14 Sep 2022 16:10
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Related URLs: https://www.mic ... 99/mic.0.001237 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2022-09-07
Accepted Date: 2022-07-19
Submitted Date: 2022-05-06
Authors: Nolan, Victoria
Harrison, James
Cox, Jonathan A.G. (ORCID Profile 0000-0001-5208-4056)



Version: Published Version

License: Creative Commons Attribution

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