Fed: Honey makes dialysis sweeter for renal failure patients

AAP General News (Australia)
08-25-2005
Fed: Honey makes dialysis sweeter for renal failure patients

By Janelle Miles, National Medical Correspondent

BRISBANE, Aug 25 AAP - Honey is mentioned in the Bible, the Koran and the Torah as
being used for healing purposes.

Now, Australian researchers have found it's just as effective as an antibiotic cream
to prevent infections when applied to catheter sites in kidney dialysis patients.

Kidney specialist David Johnson said honey also had an advantage over the commonly-used
antibiotic ointment, mupirocin, in that hospital "superbugs" had not developed resistance
to it.

Nephrologists, like Professor Johnson, have been concerned that bugs such as Staphylococcus
aureus, commonly known as Golden staph, and vancomycin-resistant enterococci (VRE) have
developed resistance to mupirocin.

"Honey covers a broader spectrum of bugs. It covers bacteria and fungi as well as many
super-resistant bugs like VRE and Golden staph," said Prof Johnson, of Brisbane's Princess
Alexandra Hospital.

"There are no documented cases of honey-resistant bacteria."

Prof Johnson and colleagues compared a specially-formulated honey, sold as Medihoney,
with mupirocin cream applied to catheter sites in patients with renal failure undergoing
haemodialysis.

They randomly selected 101 patients between February 2002 and July 2004 at the PA Hospital,
where Prof Johnson is director of renal medicine.

Half of the patients were treated with the Medihoney and half were given the standard
treatment with the antibiotic cream.

The treatment was applied three times a week - every time they came to the hospital for dialysis.

Patients on both treatments recorded less than one infection per 1,000 catheter days.

"We found that honey was actually as effective as the mupirocin and was safe and well
tolerated but it didn't induce any microbial resistance whereas mupirocin does," Prof
Johnson said.

The results of the trial, published in the Journal of the American Society of Nephrology,
prompted the hospital's renal unit, after consultation with infectious disease specialists,
to switch to Medihoney.

"Before we changed over to Medihoney we had already started to see a few treatment
failures where we had applied the mupirocin ointment," Prof Johnson said.

"In those cases, we got a bloodstream infection because of bugs that had become resistant
to the antibiotic.

"Our concern would be that if we had kept going with the antibiotic ointment, ultimately
it would end up being ineffective, like most other antibiotics when the bugs become resistant
to them."

Prof Johnson said he'd been told other renal units throughout Australia, the United
States and Europe had also switched to the honey.

He expected the Medihoney would prove equally effective in other people requiring catheters
such as cancer sufferers receiving chemotherapy and patients who require fluids to be
administered intravenously.

"I believe that there are several intensive care units that are looking at this," Prof
Johnson said.

He said catheter-associated bloodstream infections among dialysis patients were extremely
serious.

"Every time someone gets a bloodstream infection, they're in hospital at least a couple
of weeks, costing about $2,000 per episode for hospitalisation and antibiotics," Prof
Johnson said.

"Five per cent of such patients then get serious infections of their heart valves and
about seven and a half per cent get serious infections of the spinal cord."

Prof Johnson said infection rates were much lower in renal failure patients who had
undergone surgery to join an artery and a vein in their arm, giving them permanent dialysis
access and eliminating the need for a catheter.

But he said around 16 per cent of kidney dialysis patients across Australia required
temporary dialysis catheters.

"The reality is, because access surgery is extremely limited these days (because of
long, surgical waiting lists in the public hospital sector), about 70 per cent of new
patients will have a catheter," Prof Johnson said.

He said Medihoney, also used to treat ulcers in diabetic patients to promote wound
healing, cost around $15 a tube, similar in price to mupirocin cream.

One tube lasts several months per patient.

Medihoney, produced by a Brisbane-based company, contains a blend of honeys selected
for their antibacterial activity, such as those derived from flowers of Australia's Leptospermum
tree.

Prof Johnson, from the Renal Medicine Department at the University of Queensland, warned
people against using honey out of the cupboard.

"You can't just take the honey out of the pantry and stick it on a wound," he said.

"Medihoney is specially treated to remove bacterial spores."

Medihoney Pty Ltd is a subsidiary of Capilano Honey Ltd, listed on the Bendigo Stock Exchange.

Prof Johnson plans a multi-centre trial of the honey among renal dialysis patients
in hospitals around Australia and New Zealand.

AAP jhm/jt/de

KEYWORD: KIDNEYS (PIX AVAILABLE) (AAP NEWSFEATURE)

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