Cited by 162Central Venous Catheters and HemodialysisInfection Control in HealthcareUrinary Tract Infections Management

Randomized, controlled trial of topical exit-site application of honey (medihoney) versus mupirocin for the prevention of catheter-associated infections in hemodialysis patients

Johnson, David Wayne, van Eps, Carolyn, Mudge, David William, Wiggins, Kathryn Joan, Armstrong, Kirsty, Hawley, Carmel Mary, Campbell, Scott Bryan, Isbel, Nicole Maree +2 more·2005·Journal of the American Society of Nephrology

Abstract

The clinical usefulness of hemodialysis catheters is limited by increased infectious morbidity and mortality. Topical antiseptic agents, such as mupirocin, are effective at reducing this risk but have been reported to select for antibiotic-resistant strains. The aim of the present study was to determine the efficacy and the safety of exit-site application of a standardized antibacterial honey versus mupirocin in preventing catheter-associated infections. A randomized, controlled trial was performed comparing the effect of thrice-weekly exit-site application of Medihoney versus mupirocin on infection rates in patients who were receiving hemodialysis via tunneled, cuffed central venous catheters. A total of 101 patients were enrolled. The incidences of catheter-associated bacteremias in honey-treated (n = 51) and mupirocin-treated (n = 50) patients were comparable (0.97 versus 0.85 episodes per 1000 catheter-days, respectively; NS). On Cox proportional hazards model analysis, the use of honey was not significantly associated with bacteremia-free survival (unadjusted hazard ratio, 0.94; 95% confidence interval, 0.27 to 3.24; P = 0.92). No exit-site infections occurred. During the study period, 2% of staphylococcal isolates within the hospital were mupirocin resistant. Thrice-weekly application of standardized antibacterial honey to hemodialysis catheter exit sites was safe, cheap, and effective and resulted in a comparable rate of catheter-associated infection to that obtained with mupirocin (although the study was not adequately powered to assess therapeutic equivalence). The effectiveness of honey against antibiotic-resistant microorganisms and its low likelihood of selecting for further resistant strains suggest that this agent may represent a satisfactory alternative means of chemoprophylaxis in patients with central venous catheters.

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Crossref · 10.1681/asn.2004110997

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  • Prevention of exit site infection by coating catheters with honey was found to be at least as effective as povidone iodine or mupirocin.

    “For example, prevention of exit site infection by coating catheters with honey was found to be at least as effective as povidone iodine [254] or mupirocin [255].”

    From Candida glabrata Biofilms: How Far Have We Come? (2017) · cites this paper as [255]

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Authors
Johnson, D. W., van Eps, C., Mudge, D. W., Wiggins, K. J., Armstrong, K., Hawley, C. M., Campbell, S. B., Isbel, N. M., Nimmo, G. R., & Gibbs, H.
Affiliations
The University of Queensland (AU)
Corresponding author
Johnson, David Wayne
Venue
Journal of the American Society of Nephrology
Published
2005-05
Volume
16
Issue
5
Pages
1456-1462
ISSN
1046-6673 (ISSN-L)
OpenAlex
W2139683791
Cited by
162
References
41
Citations by year
2026: 1 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 8 · 2019: 6 · 2018: 4 · 2017: 2 · 2016: 9 · 2015: 10 · 2014: 7 · 2013: 13 · 2012: 10
FWCI
15.42
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of the American Society of Nephrology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Smith and Nephew
Topics
  • Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
Keywords
honey, mupirocin, catheter exit site infection, catheter-related bacteremia, hemodialysis catheter, central venous catheters, antibiotic resistance, topical antibiotics, infection control, staphylococcal isolates
MeSH terms
Adult, Aged, Anti-Bacterial Agents, Bandages, Catheterization, Central Venous, Female, Renal Dialysis, Honey, Humans, Kidney Failure, Chronic, Male, Middle Aged, Risk Factors, Bacteremia, Drug Costs, Mupirocin, Disease-Free Survival

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