Manuka

Generic name: Leptospermum Scoparium J.R. Forst. Et G. Forst.
Brand names: Manuka Honey, Manuka Oil, Red Manuka

Usage of Manuka

Antimicrobial

Animal and in vitro data

Manuka oil has selective antibacterial activity against gram positive organisms(Harkenthal 1999) such as Staphylococcus aureus and Micrococcus luteus.(Rhee 1997) Manuka oil has little to no activity against gram-negative organisms such as Pseudomonas aeruginosa, EscheriChia coli, KlebsiElla pneumoniae, and Proteus vulgaris.(Harkenthal 1999, Kim 1999, Rhee 1997)

In vitro, Manuka Honey effectively inhibited biofilm formation by C. difficile strains of different polymerase chain Reaction ribotypes.(Piotrowski 2017)

In vitro experiments concluded that Manuka oil may be an effective alternative to antibiotics for the treatment of topical staphylococcal infections.(Fratini 2017) A review found extensive in vitro data supporting the antimicrobial effects of Manuka oil and suggested further clinical studies to establish its therapeutic potential. Clinical evidence on Manuka oil's efficacy, safety, and dosing guidelines are necessary for its implementation for medical purposes.(Mathew 2020)

Successful studies have been conducted on wound healing in animals, especially in horses and dogs.(Bensignor 2016, Carter 2016)

Clinical data

Studies have evaluated the efficacy of Manuka honey in healing infected wounds. In neuropathic diabetic foot ulcers, Manuka honey-impregnated dressings increased healing rates and reduced the need for antibiotics in a clinical study of 63 patients versus saline dressings. However, the percentage of healed ulcers was not affected.(Kamaratos 2014) While the role of honey as an anti-infective agent has been described, the additive efficacy of Manuka in the honey has not been established in robust clinical trials.(Carter 2016, White 2016)

Anti-inflammatory effects

Animal data

Anti-inflammatory and immunomodulatory effects have been described in published reviews.(White 2016)

Clinical data

A small clinical trial (n=19) evaluated Manuka with Kanuka essential oils as a gargle for benefit on radiotherapy-induced mucositis and symptoms. Mucositis reportedly developed significantly later in patients with the active gargle. The small sample size of most of the variables prevented further statistical comparisons. Mean pain scores gradually increased over treatment time with fewer patients in the active gargle group experiencing scores of 3 or higher and going the longest until that level of pain was reached; this was also reflected in the use of daily analgesics. Interestingly, patients with more family members present during treatment tended to report more frequent and more severe pain than those without family members present.(Maddocks-Jennings 2009)

Manuka, as the honey, has been studied in radiotherapy-induced mucositis in limited clinical trials finding no improvement on mucositis, and some effect on bacterial infection.(Bardy 2012, Hawley 2014)( Bardy, Hawley) A study conducted in patients with rhinosinusitis, using mankua honey nasal spray, found no endoscopically validated improvement in symptoms.(Thamboo 2011)

Other uses

The in vitro activity of Manuka oil was analysed by agar disk diffusion and minimum inhibitory concentration methods. The results demonstrated the efficacy of Manuka essential oils and supported their application as a natural alternative treatment against Candida spp.(Elisa 2021)

L. scoparium essential oil is a promising source of mosquito larvicide and its toxicity is enhanced by a biobased emulsifier.(Muturi 2020)

The pharmacological action of Manuka oil for treating diarrhea, colds, and inflammation was studied on a field-stimulated guinea pig ileum. Manuka oil induced a spasmolytic effect(Lis-Balchin 2000, Lis-Balchin 1998); the mechanism of action is likely to be the result of a postsynaptic mechanism and associated with cAMP.(Lis-Balchin 1998)

L. scoparium contains a lipophilic flavonoid that specifically interacts with benzodiazepine receptors in the GABA-A receptor-chloride channel complex. A sedating and potentially anxiolytic effect was recorded in a locomotion study with rats.(Häberlein 1994, Häberlein 1994)

There is currently not enough evidence to recommend the use of Manuka honey for atopic dermatitis therapy.(Shi 2019)

Manuka side effects

Clinical studies of Manuka honey in mucositis found tolerability of dosage regimens to be poor.Bardy 2012, Hawley 2014

L. scoparium contains a lipophilic flavonoid that specifically interacts with benzodiazepine receptors (GABA-A receptor-chloride channel complex).Bardy 2012, Hawley 2014

Before taking Manuka

Documented adverse effects. Avoid use during pregnancy because of reported spasmolytic activity.Lis-Balchin 2000, Lis-Balchin 1998

How to use Manuka

There are no reported clinical studies of Manuka oil on which dosage recommendations can be based.

Manuka honey has been used anecdotally as a probiotic. A study evaluated the safety of consuming 20 g of honey daily for 4 weeks and found no adverse effects on GI flora.(Wallace 2010) 20 mL of the honey taken 4 times daily for 6 weeks was evaluated in oral mucositis.(Bardy 2012)

Warnings

There are limited clinical toxicological data on Manuka oil in the scientific literature. Anecdotal information from OTC use of topical Manuka oil products suggest good potential for its future use as an antimicrobial agent.(Porter 2001) Avoid use during pregnancy because of reported spasmolytic activity.(Lis-Balchin 2000, Lis-Balchin 1998)

What other drugs will affect Manuka

None well documented.

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