Table 1.
Bacterial species found to be susceptible to therapeutic manuka honey.
| Bacterial species1 | No. isolates2 | Honey type3 | MIC (%v/v)4 | Reference |
|---|---|---|---|---|
| Acinetobacter baumannii | 11 (C) | Medihoney® (AUST) | 6–8S | George and Cutting, 2007 |
| 1 (C) | Medical manuka 1 | 6S | Carnwath et al., 2014 | |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 4S | ||
| 1 (C) | Manuka 10+ (UB) | 12S | ||
| Acinetobacter calcoaceticus | 4 | Medihoney® (AUST) | 8.1S | Blair et al., 2009 |
| Actinomyces pyogenes | 1 (C) | Manuka (1) | 5S | Allen and Molan, 1997 |
| Alcaligenes faecalis | 1 (C) | Manuka 10+ (CNZ) | 25 | Mundo et al., 2004 |
| Bacillus cereus | 1 (C) | Manuka 10+ (CNZ) | 25 | |
| Bacillus stearothermophilus | 1 (C) | Manuka 10+ (CNZ) | 50 | |
| Bacillus subtilis | 1 | Manuka 10+ (CNZ) | 10 | Balan et al., 2016 |
| Burkholderia ambifaria | 4 (C) | Woundcare 18+ (CUK/NZ) | 4.5 | Jenkins et al., 2015b |
| Burkholderia anthina | 4 (C) | Woundcare 18+ (CUK/NZ) | 4.25 | |
| Burkholderia cenocepacia | 15 (C) | Woundcare 18+ (CUK/NZ) | 4.5 | |
| Burkholderia cepacia | 20 (C) | Manuka (2) | 2–5S | Cooper et al., 2000 |
| 6 (C) | Woundcare 18+ (CUK/NZ) | 5.2 | Jenkins et al., 2015b | |
| Burkholderia cepacia complex | 4 (C) | Woundcare 18+ (CUK/NZ) | 4 | |
| Burkholderia cepacia group K | 3 (C) | Woundcare 18+ (CUK/NZ) | 4.3 | |
| Burkholderia multivorans | 10 (C) | Woundcare 18+ (CUK/NZ) | 4.6 | |
| Burkholderia pyrrocinia | 2 (C) | Woundcare 18+ (CUK/NZ) | 5 | |
| Burkholderia stabilis | 1 (C) | Woundcare 18+ (CUK/NZ) | 5 | |
| Burkholderia vietnamensis | 5 (C) | Woundcare 18+ (CUK/NZ) | 4.8 | |
| Citrobacter freundii | 2 | Medihoney® (AUST) | 9.1S | Blair et al., 2009 |
| Clostridium difficile | 3 (2C) | Woundcare 18+ (CNZ) | 6.25 | Hammond and Donkor, 2013 |
| Enterobacter aerogenes | 1 | Medihoney® (AUST) | 13.8S | Blair et al., 2009 |
| 1 (C) | Manuka 16+ (SG) | 11.9S | Lin et al., 2011 | |
| Enterobacter agglomerans | 1 | Medihoney® (AUST) | 7S | Blair et al., 2009 |
| Enterobacter clocae | 6 (C) | Medihoney® (AUST) | 6 | George and Cutting, 2007 |
| 18 | Medihoney® (AUST) | 11.8S | Blair et al., 2009 | |
| 1 (C) | Manuka 16+ (SG) | 10.65S | Lin et al., 2011 | |
| ESBL producing Enterobacter clocae | 1 | Manuka 16+ (SG) | 5.9S | |
| ESBL producing Enterobacter sp. | 1 | Manuka 16+ (SG) | 5.9S | |
| Enterococcus faecalis | 3 (C) | Medihoney® (AUST) | 6–8 | George and Cutting, 2007 |
| 1 (C) | Medical manuka 1 | 8S | Carnwath et al., 2014 | |
| 1 (C) | Medical manuka 2 | 12S | ||
| 1 (C) | Manuka 20+ (UB) | 6S | ||
| 1 (C) | Manuka 10+ (UB) | 10S | ||
| Enterococcus sp. | 7 (C) | Manuka (3) | 4.7–5S | Cooper et al., 2002b |
| 3 (C) | Medihoney® (AUST) | 6 | George and Cutting, 2007 | |
| VRE | 20 | Manuka (3) | 3.8–5S | Cooper et al., 2002b |
| 20 (C) | Medihoney® (AUST) | 6–8 | George and Cutting, 2007 | |
| Escherichia coli | 10 (C) | Medihoney® (AUST) | 6–8 | |
| 1 | Medical manuka 3 | 5S | Wilkinson and Cavanagh, 2005 | |
| 1 | Medihoney | 2.5S | ||
| 1 | Manuka 10+ (CNZ) | 20 | Balan et al., 2016 | |
| 9 | Medihoney® (AUST) | 7.5S | Blair et al., 2009 | |
| 1 (C) | Medical manuka 1 | 6S | Carnwath et al., 2014 | |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 4S | ||
| 1 (C) | Manuka 10+ (UB) | 8S | ||
| 1 | Manuka 16+ (SG) | 6.9S | Lin et al., 2011 | |
| 1 | Manuka 25+ (CNZ) | 12.5S | Sherlock et al., 2010 | |
| 1 (C) | Woundcare 18+ (CUK/NZ) | 12.0 | Cooper et al., 2010 | |
| ESBL producing Escherichia coli | 3 | Manuka 16+ (SG) | 4.7–5.5S | Lin et al., 2011 |
| Escherichia coli 0157:H7 | 1 (C) | Manuka 10+ (CNZ) | 50 | Mundo et al., 2004 |
| 1 | Manuka 10+ (CNZ) | 10 | Balan et al., 2016 | |
| Helicobacter pylori | 28 (C) | Manuka (AHNZ) | 10S | Osato et al., 1999 |
| 7 (C) | Manuka (2) | 5S | Al Somal et al., 1994 | |
| Klebsiella pneumonia | 1 (C) | Manuka (1) | 10S | Allen and Molan, 1997 |
| 12 (C) | Medihoney® (AUST) | 6–8 | George and Cutting, 2007 | |
| 7 | Medihoney® (AUST) | 13S | Blair et al., 2009 | |
| Listeria monocytogenes | 1 | Manuka 10+ (CNZ) | 20 | Balan et al., 2016 |
| Morganella morganii | 1 | Medihoney® (AUST) | 7.8S | Blair et al., 2009 |
| Nocardia asteroides | 1 (C) | Manuka (1) | 5S | Allen and Molan, 1997 |
| Proteus mirabilis | 1 | Manuka (1) | 10.8 | Willix et al., 1992 |
| Proteus vulgaris | 1 | Manuka 10+ (CNZ) | 20 | Balan et al., 2016 |
| Pseudomonas spp. | 20 (C) | Manuka (2) | 5.5–8.7 | Cooper and Molan, 1999 |
| Pseudomonas aeruginosa | 17 (C) | Manuka (3) | 4–9S | Cooper et al., 2002a |
| 1 | Manuka (1) | 15.7 | Willix et al., 1992 | |
| 20 (C) | Medihoney® (AUST) | 12–14 | George and Cutting, 2007 | |
| 1 | Medical manuka 3; Medihoney | 2.5S | Wilkinson and Cavanagh, 2005 | |
| 112 (C) | Manuka (AUST UB) | 20 | Mullai and Menon, 2007 | |
| 1 | Manuka (AUST UB) | 10 | ||
| 40 (E) | Manuka (AUST UB) | 20 | ||
| 56 (C) | Woundcare 18+ (CUK/NZ) | 7.3 | Jenkins et al., 2015b | |
| 1 (C) | Manuka MGO550 | 12.5 | Anthimidou and Mossialos, 2012 | |
| 1 (C) | Medical manuka 1 | 8S | Carnwath et al., 2014 | |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 8S | ||
| 1 (C) | Manuka 10+ (UB) | 10S | ||
| 3 (2C) | Medihoney® (CNZ) | 10–30% | Kronda et al., 2013 | |
| 1 | Woundcare 18+ (CUK/NZ) | 6 | Jenkins and Cooper, 2012 | |
| 1 | Medical manuka 4 | 12 | Roberts et al., 2012 | |
| 2 (1C) | Medihoney® (CNZ) | 10–30 | Maddocks et al., 2013 | |
| 1 | Manuka (3) | 9.5S | Henriques et al., 2011 | |
| 1 | Manuka 25+ (CNZ) | 12.5S | Sherlock et al., 2010 | |
| 1 | Woundcare 18+ (CUK/NZ) | 15.7 | Cooper et al., 2010 | |
| Salmonella enteritidis | 1 | Manuka 10+ (CNZ) | 20 | Balan et al., 2016 |
| 1 | Manuka 16+ (SG) | 6.8S | Lin et al., 2011 | |
| Salmonella mississippi | 1 | Manuka 16+ (SG) | 6.8S | |
| Salmonella typhimurium | 1 (C) | Manuka 10+ (CNZ) | 50 | Mundo et al., 2004 |
| 1 | Manuka 10+ (CNZ) | 20 | Balan et al., 2016 | |
| 2 | Manuka 16+ (SG) | 6.8–7.5S | Lin et al., 2011 | |
| Serratia marcescens | 1 | Manuka (1) | 9.4 | Willix et al., 1992 |
| 1 | Medihoney® (AUST) | 14.8S | Blair et al., 2009 | |
| Shigella flexneri | 1 (C) | Manuka 16+ (SG) | 7.58S | Lin et al., 2011 |
| Shigella sonnei | 1 | Manuka 10+ (CNZ) | 10 | Balan et al., 2016 |
| 1 (C) | Manuka 16+ (SG) | 6.6 S | Lin et al., 2011 | |
| Staphylococcus aureus | 1 (C) | Manuka (1) | 5S | Allen and Molan, 1997 |
| 1 | Manuka (1) | 2.7 | Willix et al., 1992 | |
| 2 | Medihoney® (AUST) | 4.4S | Blair et al., 2009 | |
| 48 (C) | Medihoney® (AUST) | 4 | George and Cutting, 2007 | |
| 1 | Manuka 10+ (CNZ) | 5 | Balan et al., 2016 | |
| 1 (C) | Manuka MGO550 | 6.25 | Anthimidou and Mossialos, 2012 | |
| 4 (2C) | Manuka (5CNZ) | 8 | Lu et al., 2013 | |
| 1 (C) | Medical manuka 1 | 6S | Carnwath et al., 2014 | |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 2S | ||
| 1 (C) | Manuka 10+ (UB) | 10S | ||
| 1 | Medihoney® (CNZ) | 8 | Maddocks et al., 2013 | |
| 2 (C) | Medihoney® (CNZ) | 6–10 | ||
| 2 | Manuka (3) | 1.2–3.4 | Henriques et al., 2010 | |
| 1 | Woundcare 18+ (CUK/NZ) | 3 | Cooper et al., 2010 | |
| 58 (C) | Manuka (2) | 2–3 | Cooper et al., 1999 | |
| Staphylococcus aureus resistant to antibiotics other than methicillin | 5 (C) | Medihoney® (AUST) | 4.1S | Blair et al., 2009 |
| MRSA | 18 (C) | Manuka (3) | 2.7–3S | Cooper et al., 2002b |
| 13 (C) | Medihoney® (AUST) | 4.2S | Blair et al., 2009 | |
| 1 (C) | Medical manuka 1 | 4S | Carnwath et al., 2014 | |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 3S | ||
| 1 (C) | Manuka 10+ (UB) | 10S | ||
| 1 | Medihoney® (CNZ); Manuka (CNZ) | 8 | Müller et al., 2013 | |
| 4 (C) | Manuka 25+ (CNZ) | 12.5S | Sherlock et al., 2010 | |
| 1 | Manuka 25+ (CNZ) | 12.5S | ||
| Epidemic MRSA | 1 | Woundcare 18+ (CUK/NZ) | 6 | Jenkins and Cooper, 2012 |
| 1 | Medihoney® (CNZ) | 20 | Maddocks et al., 2013 | |
| Staphylococcus (coagulase negative) | 18 (C) | Manuka (4) | 2.7–5S | French et al., 2005 |
| Staphylococcus epidermidis | 1 (C) | Woundcare 18+ (CUK/NZ) | 7 | Cooper et al., 2010 |
| MRSE | 1 (C) | Medical manuka 1 | 4S | Carnwath et al., 2014 |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 4S | ||
| 1 (C) | Manuka 10+ (UB) | 6S | ||
| Staphylococcus equi subsp. equi | 1 (C) | Medical manuka 1 | 6S | |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 4S | ||
| 1 (C) | Manuka 10+ (UB) | 8S | ||
| Staphylococcus equi subsp. zooepidemicus | 1 (C) | Medical manuka 1 | 6S | |
| 1 (C) | Medical manuka 2 | 4S | ||
| 1 (C) | Manuka 20+ (UB) | 10S | ||
| 1 (C) | Manuka 10+ (UB) | 4S | ||
| Staphylococcus sciuri | 1 (C) | Medical manuka 1 | 4%S | |
| 1 (C) | Medical manuka 2 | 10S | ||
| 1 (C) | Manuka 20+ (UB) | 4S | ||
| 1 (C) | Manuka 10+ (UB) | 6S | ||
| Stenotrophomonas maltophilia | 20 (C) | Manuka 15+ (NN) | 7.5–22.5S | Majtan et al., 2011 |
| Streptococcus agalactiae | 1 (C) | Manuka (1) | 5S | Allen and Molan, 1997 |
| Streptococcus dysgalactiae | 1 (C) | Manuka (1) | 5S | |
| Streptococcus pyogenes | 1 | Medihoney® (CNZ) | 20 | Maddocks et al., 2012 |
| 2 (1C) | Medihoney® (CNZ) | 20 | ||
| Streptococcus uberis | 1 (C) | Manuka (1) | 5S | Allen and Molan, 1997 |
| Yersinia enterocolitica | 1 | Manuka 16+ (SG) | 4.8S | Lin et al., 2011 |
1VRE: Vancomycin-resistant Enterococcus; MRSA: Methicillin-resistantStaphylococcus aureus; MRSE: Methicillin-resistant Staphylococcus epidermidis; ESBL, Extended spectrum β-lactamase.
2Where source was specified C, clinical isolates; E, environmental isolates.
3Leptospermum honeys registered as wound care products: Medihoney® (CNZ) – A commercial sterile therapeutic honey product, proprietary blend of active Leptospermum honey, Comvita Ltd, New Zealand; Medihoney® (AUST) – A commercial sterile therapeutic honey product, proprietary blend of active Leptospermum honey and honey with high levels of hydrogen peroxide-dependent activity, Medihoney Pty Ltd., Australia; Medical manuka 1 – Commercial wound care manuka honey, unspecified brand 1; Medical manuka 2 – Commercial wound care manuka honey, unspecified brand 2; Medical manuka 3 – Commercial manuka, labeled as antibacterial, unspecified brand 3; Woundcare 18+ (CUK/NZ) – Manukacare/WoundCare 18+ UMF pure Leptospermum scoparium honey, Comvita Ltd, United Kingdom/New Zealand; Medihoney – Therapeutic manuka honey with antibacterial activity, unspecified brand; Medical manuka 4 – Sterile, medical-grade manuka honey from New Zealand (Activon, Advancis Medical, Nottingham, UK). Standadised, commercially available Leptospermum honeys with medicinal claims: Manuka 10+ (CNZ) – Manuka honey 10+ UMF (Comvita Ltd, New Zealand); Manuka 10+ (UB) – Manuka honey 10+, unspecified brand; Manuka 15+ (NN) – Manuka honey 15+ (Nature’s Nectar, New Zealand); Manuka 16+ (SG) – Manuka honey UMF16+ (SummerGlow Apiaries Ltd., New Zealand); Manuka 20+ (UB) – Manuka honey 20+, unspecified brand; Manuka 25+ (CNZ) – Manuka honey UMF 25+ (Comvita, New Zealand); Manuka MGO550 – Manuka honey MGO 550+/UMF25+, Manuka Health, New Zealand. Non-standardized Leptospermum honeys: Manuka (1) – Unpasteurised centrifugally extracted monofloral Leptospermum scoparium, New Zealand – activity 13.2% phenol; Manuka (2) – Active manuka honey, with activity equivalent to 13.2% phenol, provided by Professor Peter Molan, University of Waikato, New Zealand; Manuka (3) – Active manuka honey, with activity equivalent to 18% phenol, provided by Professor Peter Molan, University of Waikato, New Zealand; Manuka (4) – Manuka honey with NPA equivalent to 16.8% (w/v) phenol, unspecified source, New Zealand; Manuka (5CNZ) – Active manuka honey, with activity equivalent to 18% phenol, provided Comvita Ltd, New Zealand; Manuka (CNZ) – Manuka honey, from Leptospermum scoparium plantations (Hokianga, New Zealand), provided by Comvita Ltd, New Zealand; Manuka (AHNZ) – Creamed Manuka Honey, Airborne Honey Ltd., Leeston, New Zealand; Manuka (AUST UB) – Manuka honey, unspecified brand, Australia.
4Minimum inhibitory concentration. As different authors used different methods to determine MIC these may not be directly comparable between studies. S: Organism tested was more susceptible to honey than to an artificial honey solution.