Honey in the management of infections.

BACKGROUND Honey, a natural product of bees of the genera Apis and Meliponinae, has been recognized for medicinal properties since antiquity. Honey has demonstrated antimicrobial properties. These effects are variably ascribed to the pH, hydrogen peroxide content, osmotic effect, and as yet unidentified compounds putatively described as inhibines. MATERIALS AND METHODS This review will explore the use of honey in necrotizing soft tissue infections, postsurgical wound infections, wounds other than postsurgical infections, Helicobacter pylori of the stomach and duodenum, and burns. Throughout, the in vitro evidence that exists and the explanations that can be offered for the purported benefits of honey will be reviewed. Most of the reports are either uncontrolled case series or in vitro observations. As such, detailed critique of statistical methods will not be undertaken. CONCLUSION The purpose of this paper is not to debunk honey therapy as a myth, but to stimulate thought among surgeons interested in surgical infection and perhaps serve as the nidus for future research. The use of honey should be considered when more conventional therapies have failed.