Topical Wound Care Agent
Pregnancy: Safe for topical use — no systemic absorption concerns
Medical-Grade Honey (Manuka)
Brand names: Medihoney, Activon
Adult dose
Dose: Apply 20 mL (20 g) per 10 cm² of wound; reapply every 2–3 days or when saturated
Route: Topical
Frequency: Every 2–3 days
Max: As required per wound size
Medical-grade Manuka honey (UMF 10+) — antimicrobial via H2O2 production, low pH, osmotic activity, and methylglyoxal. Active against MRSA, Pseudomonas, and biofilm. Available as gel, ribbon gauze, and tulle dressings. Licensed as a medical device in UK.
Paediatric dose
Route: Topical
Frequency: Every 2–3 days
Max: As required
Safe in children — apply appropriate volume to wound. Use with caution in known bee product allergy.
Dose adjustments
Renal
No adjustment required for topical use.
Hepatic
No adjustment required.
Clinical pearls
- Honey disrupts bacterial biofilm — particularly useful in stalled wounds with clinical signs of infection without systemic sepsis
- MRSA-active — useful when topical antibiotic-resistant infection is suspected
- Autolytic debridement: the osmotic and enzymatic activity of honey aids gentle debridement of sloughy wounds without mechanical trauma
Contraindications
- Known allergy to bee products or honey
- Diabetes (monitor — systemic glucose absorption from large-area wounds is theoretical but documented)
Side effects
- Pain on application (osmotic effect — drawing exudate)
- Transient stinging
- Mild maceration of surrounding skin
- Rarely: allergic contact dermatitis
Interactions
- No significant drug interactions
Monitoring
- Wound size and appearance at each dressing change
- Blood glucose in diabetic patients (large wounds)
- Signs of allergy
Reference: BNFc; BNF 90; NICE Evidence Review on Honey Dressings; BBA Wound Care Guidelines; Cochrane Review (Honey as topical treatment for wounds, 2015). Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.