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Current Drug Discovery Technologies

Editor-in-Chief

ISSN (Print): 1570-1638
ISSN (Online): 1875-6220

Clinical Trial

Efficacy of Honey-based Ophthalmic Formulation in Patients with Corneal Ulcer: A Randomized Clinical Trial

Author(s): Mahmood Nejabat, Kazem Soltanzadeh, Masoud Yasemi*, Saeid Daneshamouz, Amin Reza Akbarizadeh and Mojtaba Heydari

Volume 18, Issue 3, 2021

Published on: 14 February, 2020

Page: [457 - 462] Pages: 6

DOI: 10.2174/1570163817666200214113055

Price: $65

Abstract

Aim: The aim of this study was to evaluate the efficacy of honey-based ophthalmic drop in patients with foreign body induced corneal ulcer.

Background: Honey is traditionally used for skin, mucosal and corneal ulcers. Its use is well studied in human skin and mucosal ulcers and animal model of corneal ulcer with promising effects.

Methods: In this randomized clinical trial, 50 patients with foreign body induced corneal ulcer were allocated to receive 70% sterile honey-based ophthalmic formulation or 0.3% ophthalmic ciprofloxacin, as the standard treatment every 6 hours. All the patients were examined for the size of corneal epithelial defect, corneal infiltration and depth and followed on a daily basis until complete healing. Duration for complete healing was considered as the outcome measure. Smear, culture, antibiogram and minimum inhibition concentration (MIC) tests were performed for honey and ciprofloxacin in all patients.

Results: The average durations of complete healing of corneal epithelial defect in the honey and ciprofloxacin groups were 3.88 ± 3.44 vs. 6.32 ± 3.69days, respectively (p=0.020). No significant difference was observed between two groups regarding an average duration of healing of corneal infiltration (8.12 ±1.94 days vs. 8.64±2.15 days, p=0.375). MIC of honey for pseudomonas aeruginosa was 60%w/w, for E.Coli 40% w/w, and for staphylococcus aureus 30% w/w.

Conclusion: Honey based ophthalmic drop can acceleratethe corneal epithelial defect healing in patients with foreign body induced corneal ulcer, compared to ophthalmic ciprofloxacin as a standard treatment.

The study was registered in Iranian registry of clinical trial center (IRCT) with registration number IRCT2015020120892N1.

Keywords: Honey, traditional medicine, ulcer, corneal ulcer, antibacterial, honey-based ophthalmic drop.

Graphical Abstract

[1]
Uwaydat S, Jha P, Tytarenko R, et al. The use of topical honey in the treatment of corneal abrasions and endotoxin-induced keratitis in an animal model. Curr Eye Res 2011; 36(9): 787-96. [eng.].
[http://dx.doi.org/10.3109/02713683.2010.544441] [PMID: 21812661]
[2]
Al-Waili NS, Salom K, Butler G, Al Ghamdi AA. Honey and microbial infections: A review supporting the use of honey for microbial control. J Med Food 2011; 14(10): 1079-96. [eng.].
[http://dx.doi.org/10.1089/jmf.2010.0161] [PMID: 21859350]
[3]
Rahimi F, Hashemian MN, Khosravi A, Moradi G, Bamdad S. Bacterial keratitis in a tertiary eye centre in Iran: a retrospective study. Middle East Afr J Ophthalmol 2015 Apr-Jun; 22: 238-44. PubMed PMID: 25949085. Pubmed Central PMCID: Pmc4411624. Epub 2015/05/08. eng.
[4]
Ormerod LD. Causes and management of bacterial keratitis in the elderly. Can J Ophthalmol 1989; 24(3): 112-6. [eng.].
[PMID: 2731071]
[5]
Wong TY, Ng TP, Fong KS, Tan DT. Risk factors and clinical outcomes between fungal and bacterial keratitis: A comparative study. CLAO J 1997; 23(4): 275-81. [eng.].
[PMID: 9348453]
[6]
Liesegang TJ. Contact lens-related microbial keratitis: Part II: Pathophysiology. Cornea 1997; 16(3): 265-73. [eng.].
[http://dx.doi.org/10.1097/00003226-199705000-00002] [PMID: 9143796]
[7]
Wong RL, Gangwani RA, Yu LW, Lai JS. New treatments for bacterial keratitis. J Ophthalmol 2012; 2012: 831502. PubMed PMID: 22991650. Pubmed Central PMCID: Pmc3444050. Epub 2012/09/20. eng.
[8]
Shenoy R, Bialasiewicz A, Khandekar R, Al Barwani B, Al Belushi H. Traditional medicine in oman: Its role in ophthalmology. Middle East Afr J Ophthalmol 2009; 16: 92-6. PubMed PMID: 20142969. Pubmed Central PMCID: Pmc2813592. Epub 2010/02/10. eng.
[http://dx.doi.org/10.4103/0974-9233.53869]
[9]
Mobarok Ali AT, al-Swayeh OA. Natural honey prevents ethanol-induced increased vascular permeability changes in the rat stomach. J Ethnopharmacol 1997; 55(3): 231-8. [eng.].
[http://dx.doi.org/10.1016/S0378-8741(96)01504-8] [PMID: 9080344]
[10]
Chang J, Cuellar NG. The use of honey for wound care management: a traditional remedy revisited. Home Healthc Nurse 2009; 27(5): 308-16. [eng.].
[http://dx.doi.org/10.1097/01.NHH.0000356783.00998.fa] [PMID: 19448499]
[11]
Al-Nahari AA, Almasaudi SB. Antimicrobial activities of Saudi honey against Pseudomonas aeruginosa. Saudi J Biol Sci 2015; 22: 521. quiz 17-8. PubMed PMID: 19448499. Epub 2009/05/19. eng.
[12]
Molan P, Rhodes T. Honey: A biologic wound dressing. Wounds 2015; 27(6): 141-51. [eng.].
[PMID: 26061489]
[13]
Erejuwa OO, Sulaiman SA, Ab Wahab MS. Honey: A novel antioxidant. Molecules 2012; 17(4): 4400-23.
[http://dx.doi.org/10.3390/molecules17044400] [PMID: 22499188]
[14]
Intl A. Official methods of analysis of AOAC International. Arlington, Va: AOAC Intl pv (loose-leaf) 1995.
[15]
Mohammadpour M, Mohajernezhadfard Z, Khodabande A, Vahedi P. Antibiotic susceptibility patterns of pseudomonas corneal ulcers in contact lens wearers. Middle East Afr J Ophthalmol 2011; 18(3): 228-31.
[http://dx.doi.org/10.4103/0974-9233.84053] [PMID: 21887079]
[16]
Somabhai Katara R, Dhanjibhai Patel N, Sinha M. A clinical microbiological study of corneal ulcer patients at western Gujarat, India. Acta Med Iran 2013; 51(6): 399-403. [eng.].
[PMID: 23852845]
[17]
Allen P. Corneal abrasions. Anaesthesia 1998; 53(6): 611. [eng.].
[PMID: 9709165]
[18]
Ahmed F, House RJ, Feldman BH. Corneal Abrasions and Corneal Foreign Bodies. Prim Care 2015; 42(3): 363-75. [eng.].
[http://dx.doi.org/10.1016/j.pop.2015.05.004] [PMID: 26319343]
[19]
Sharma A. Challenges in the management of corneal ulcer. Nepal J Ophthalmol 2011; 3(2): 216-7. [eng.].
[http://dx.doi.org/10.3126/nepjoph.v3i2.5283] [PMID: 21876604]
[20]
Mandal MD, Mandal S. Honey: Its medicinal property and antibacterial activity. Asian Pac J Trop Biomed 2011; 1(2): 154-60.
[http://dx.doi.org/10.1016/S2221-1691(11)60016-6] [PMID: 23569748]
[21]
Aurongzeb M, Azim MK. Antimicrobial properties of natural honey: A review of literature. Pak J Biochem Mol Biol 2011; 44: 118-24.
[22]
Zainol MI, Mohd Yusoff K, Mohd Yusof MY. Antibacterial activity of selected Malaysian honey. BMC Complement Altern Med 2013 Jun 10; 13: 129.
[http://dx.doi.org/10.1186/1472-6882-13-129]
[23]
Blair SE, Cokcetin NN, Harry EJ, Carter DA. The unusual antibacterial activity of medical-grade Leptospermum honey: antibacterial spectrum, resistance and transcriptome analysis. Eur J Clin Microbiol Infect Dis 2009; 28(10): 1199-208.
[http://dx.doi.org/10.1007/s10096-009-0763-z] [PMID: 19513768]
[24]
Cooper RA, Jenkins L, Henriques AF, Duggan RS, Burton NF. Absence of bacterial resistance to medical-grade manuka honey. Eur J Clin Microbiol Infect Dis 2010; 29(10): 1237-41.
[http://dx.doi.org/10.1007/s10096-010-0992-1] [PMID: 20549529]
[25]
Eteraf-Oskouei T, Najafi M. Traditional and modern uses of natural honey in human diseases: a review. Iran J Basic Med Sci 2013 Jun; 16: 731-42.
[26]
Kursikov AI. [Honey therapy in ophthalmology]. Oftalmol. Zh 1974; 29(4): 312. [Honey therapy in ophthalmology]. [Medolechenie v oftal'mologii. rus.].
[PMID: 4427741]
[27]
Majtánová N, Cernák M, Nekorancová J, Cernák A, Majtán J. [The potential use of honey in ophthalmology]. Cesk Slov Oftalmol 2013; 69(3): 128-32. [The potential use of honey in ophthalmology]. [ Moznosti vyuzitia vcelieho medu v oftalmologii. cze.].
[PMID: 24437960]
[28]
Cernak M, Majtanova N, Cernak A, Majtan J. Honey prophylaxis reduces the risk of endophthalmitis during perioperative period of eye surgery. Phytother Res 2012; 26(4): 613-6. [eng.].
[http://dx.doi.org/10.1002/ptr.3606] [PMID: 22508360]
[29]
Nejabat M, Astaneh A, Eghtedari M, Mosallaei M, Ashraf MJ, Mehrabani D. Effect of honey in Pseudomonas aeruginosa induced stromal keratitis in rabbits. J Appl Anim Res 2009; 35: 101-4.
[http://dx.doi.org/10.1080/09712119.2009.9706996]
[30]
Albietz JM, Lenton LM. Effect of antibacterial honey on the ocular flora in tear deficiency and meibomian gland disease. Cornea 2006; 25(9): 1012-9. [eng.].
[http://dx.doi.org/10.1097/01.ico.0000225716.85382.7b] [PMID: 17133045]
[31]
Tan JJ, Azmi SM, Yong YK, Cheah HL, Lim V, Sandai D, et al. Tualang honey improves human corneal epithelial progenitor cell migration and cellular resistance to oxidative stress in vitro. PLoS One 2014. 9.e96800 PubMed PMID: 24802273. Pubmed Central PMCID: Pmc4011849. Epub 2014/05/08. eng

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