A mixture of honey and vinegar has been used medicinally throughout history. Contemporary science has now recognized its potential use in wound care. A recent study published in the journal Microbiology is the first to fully explore how this ancient mixture could be used in modern medicine and improve the treatment of infections.
Bacterial infections are difficult to treat, especially when they are protected by biofilms. Biofilms are complex systems of bacteria that can cling tightly to surfaces, such as flesh in the case of an infected wound. Bacteria protected by biofilms are difficult to kill, and current treatments are not necessarily effective in removing them.
Previous research has shown that some natural remedies can be effective in treating infections. Manuka honey has been shown to have antibacterial properties and aid in wound healing, while vinegar has also been shown to be an effective antiseptic.
Today, doctors are applying this information into medicine. While they use manuka honey to treat antibiotic infections, they only use acetic acid, the active ingredient in vinegar, and have not yet combined the two.
Dr Erin Connelly, Dr Freya Harrison and their team from the University of Warwick have for the first time explored what happens when a combination of honey and vinegar is applied to bacterial biofilms grown in the laboratory.
After discovering this gap, the researchers first studied the effects of two medical-grade honey ointments combined with natural vinegar or acetic acid. They wanted to know how well the treatment killed microbes and which combination worked best.
They also wanted to know whether full vinegar was more antibacterial than acetic acid. Dr Erin Connelly, a researcher on the study, said: "In our investigation of early recipes, we noticed a pattern of combining honey and vinegar to cleanse or dress wounds and swelling, which inspired us to focus on this combination in our analysis."
By comparing vinegar and acetic acid alone and in combination with medical-grade honey, the researchers found that the combination of the two substances worked best. "We used a low dose of honey, which alone didn't kill the bacteria, and a low dose of acetic acid, but acetic acid alone didn't kill the bacteria," Dr. Harrison said. "These doses are lower than what wound care nurses currently use on patients. But when we combined these low doses together, we saw a lot of bacterial death, which is really exciting. We really need to study whether combining these substances can help patients who don't respond to one of these substances alone," Dr. Harrison said.
Researchers also found that some natural vinegars were more capable of killing bacteria than equivalent doses of pure acetic acid. Of these, pomegranate vinegars are candidates worthy of further study; they have strong antibacterial activity and, like acetic acid, are active when mixed with honey.
While more research is needed to understand the mechanism and optimal dosage combination of honey and vinegar, these promising results have proven exciting enough that researchers are now proposing to introduce a modern version of Oxymer into clinical trials.
Professor Joseph Hardwicke, consultant orthopedic surgeon at University Hospitals Coventry and Warwickshire, explained: "The use of traditional therapies in the modern NHS is an exciting area of research. The burden of wound care and infection is increasing year on year, as are causative factors such as diabetes. Perhaps we can use ancestral knowledge to provide better care for patients at a lower cost."