Honey ineffective in preventing peritoneal dialysis-related infections

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Honey ineffective in preventing peritoneal dialysis-related infections
Johnson DW. Lancet Infect Dis. 2013;doi:10.1016/S1473-3099(13)70258-5.

October 12, 2013

Honey did not prevent infections related to peritoneal dialysis, according to researchers from the University of Queensland in Brisbane, Australia.


“In a randomized controlled trial of participants undergoing hemodialysis, topical application of standardized antibacterial honey to hemodialysis-catheter exit sites resulted in infection rates similar to mupirocin, without the problems associated with mupirocin resistances,” the researchers wrote in The Lancet Infectious Diseases.

The open-label trial, which was coordinated by the Australasian Kidney Trials Network, included 371 participants who were randomly assigned in a 1:1 ratio to topical exit-site application with antibacterial honey plus standard exit-site care or intranasal mupirocin prophylaxis plus standard exit-site care. Participants were recruited from Sept. 17, 2008, to June 17, 2011, and the primary endpoint was time to first infection related to dialysis.

Among those who received honey, the median infection-free survival time was 16 months, and not significantly different from that of the control group time of 17.7 months (HR=1.12; 95% CI, 0.83-1.51). Among patients with diabetes who received the honey, there was a significantly higher risk of the primary endpoint (HR=1.85; 95% CI, 1.05-3.24) and a higher risk for peritonitis (HR=2.25; 95% CI, 1.16-4.36). Among participants without diabetes, there was no difference in the primary endpoint between the groups, but the risk for peritonitis was lower in the honey group (HR=0.62; 95% CI, 0.38-1.0).

“The findings might also have implications for the use of honey for the prevention of device-associated infections in general,” the researchers wrote. “In future studies of interventions to prevent peritoneal-dialysis–associated infections, randomization should include stratification for diabetes mellitus and consideration of a head-to-head comparison of nasal versus exit-site application of mupirocin.”

Disclosure: The researchers report financial relationships with Baxter Healthcare, Fresenius Medical Care and Gambro.

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