Manuka Honey Kills MRSA: What the Science Says

Does Manuka Honey Kill MRSA? (What Lab Studies Show)

Yes.

Laboratory studies show that Manuka honey kills MRSA. Multiple independent studies demonstrate bactericidal (bacteria-killing) activity at concentrations ranging from 5-20% (w/v - or weight by volume).

Both medical-grade sterilised Manuka honey and Manuka honey with verified levels of MGO (including UMF™ certified) have shown this effectiveness, with the concentration of MGO appearing to be a key factor in killing MRSA.

But here's the important caveat: Most evidence comes from laboratory (in-vitro) studies. One animal study exists (in rabbits). Clinical evidence in humans is limited to case studies and anecdotal reports.

This doesn't mean it doesn't work in humans, nor does it mean that you shouldn’t try it (with your doctor’s approval, of course). It just means that rigorous clinical trials are still needed before we can make more generalised claims about Manuka honey’s effectiveness in treating MRSA.

The evidence at a glance:

Here’s an overview of what has been shown in research:

• Müller et al. (2013) found complete inhibition of MRSA when using a 6-8% concentration of medical-grade Medihoney (w/v)¹².

• Kot et al. (2020) determined a minimum inhibitory concentration, minimum bactericidal concentration, and minimum biofilm inhibitory concentration of 12.5% using MGO-certified honey⁹.

• Jenkins et al. (2011) observed growth inhibition at 5-20% (w/v)¹⁴.

• Frydman et al. (2020) demonstrated excellent bactericidal activity at concentrations of 10% or higher using raw honey processed in the laboratory⁸.

• Alandejani et al. (2009) achieved a 63% bactericidal rate using gamma-irradiated Manuka honey¹⁵.

• The animal study: Tahir et al. (2024) showed Manuka honey combined with fusidic acid significantly improved wound healing in MRSA-infected rabbit wounds, compared to antibiotic treatments on their own⁷.

This evidence tells us that in laboratory experiments, Manuka honey was highly effective at killing MRSA, even when highly diluted.

But how Manuka honey does this is even more fascinating…

How Manuka Honey MRSA Treatments Work: Key Mechanisms

Conventional antibiotics tend to work through a single mechanism. However, Manuka honey treats infections through multiple pathways at the same time, which may be part of the reason why bacteria haven't developed resistance to it.

This multi-pronged attack overwhelms bacterial defences. Here’s how:

Disrupting cell division

A 2011 study discovered that Manuka honey interrupts the fundamental process MRSA uses to reproduce¹⁴. Under electron microscopes, researchers observed enlarged, septated cells frozen mid-division:

"Enlarged cells containing septa were observed in MRSA exposed to inhibitory concentrations of manuka honey, suggesting that cell division was interrupted," the study reported¹⁴.

But here's the critical insight: "These changes were not caused by either the sugars or methylglyoxal in honey and indicate the presence of additional antibacterial components in manuka honey"¹⁴.

This explains why Manuka honey specifically (not just sugar solutions or MGO alone) is effective. While we don’t yet have a complete understanding of precisely what it is in Manuka honey that disrupts cell division, what we do know is that it works when tested in laboratory settings.

Destroying biofilms

Biofilms are protective fortresses that bacteria build around themselves, making them up to 1,000 times more resistant to antibiotics¹⁹.

MRSA forms these biofilms in wounds and on medical devices, which is why infections are so difficult to treat.

Manuka honey attacks biofilms on multiple levels.

A 2009 study found exceptional effectiveness at removing biofilms: "The bactericidal rates for the Sidr and Manuka honeys against MSSA, MRSA, and PA biofilms were... 73–63 percent, respectively. These rates were significantly higher (P≤0.001) than those seen with single antibiotics commonly used against SA [Staphylococcus aureus]"¹⁵.

And this 2020 paper identified the genetic mechanism: "Manuka honey downregulated the genes encoding laminin- (eno), elastin- (ebps)- and fibrinogen binding protein (fib), and icaA and icaD involved in biosynthesis of polysaccharide intercellular adhesin,"⁹.

In other words, Manuka honey stops bacteria from building a protective slime layer (biofilm) by turning down the ‘instructions’ (genes) that help them stick to things and each other, preventing biofilm formation before it starts.

Within 8-12 hours, Manuka honey reduced MRSA metabolic activity by 65-70%⁹. For complete biofilm eradication, a 25% (w/v) concentration was needed⁹.

The MGO factor: critical but not sufficient alone

Methylglyoxal (MGO) is the most studied antibacterial compound in Manuka honey, and it's clearly important.¹⁰

This 2011 paper found that "methylglyoxal was a major bactericidal factor in manuka honey, but after neutralization of this compound manuka honey retained bactericidal activity due to several unknown factors"¹⁶.

This demonstrates that while MGO is crucial, it's not the whole story. Other compounds in Manuka honey also contribute to its effectiveness.

So if you’re thinking about using Manuka honey for MRSA, it’s essential to know that what you’re buying is the real deal, as many products on the market are diluted, adulterated or fake.

More info: Fake honey: What you need to know about counterfeit honey (and how to avoid buying it)

Concentration and preparation matter

The amount of Manuka honey and how it's prepared significantly affects antibacterial activity. In the studies referenced, Manuka honey was diluted to different concentrations, measured as a percentage of the weight by volume (w/v).

The studies found that the concentration needed to be effective varied depending on use:

• Planktonic (free-floating) MRSA required 5-12.5% Manuka honey to be effective in most studies

• To remove a biofilm, a 25-50% Manuka honey concentration was required

• Most studies across the board used 5-20% concentrations of Manuka honey

Preparation method matters too.

A 2020 paper found that "by using a low pressure and temperature approach, we also demonstrate the retained biologic activity of the honey and the detrimental effect of high heat on the honey"⁸.

That’s because heat degrades the beneficial compounds. Using minimally processed Manuka honey retains more antibacterial activity than heavily processed alternatives.

But perhaps the most exciting part of the research findings is what happens when Manuka honey is combined with conventional antibiotics.

Manuka Honey and Antibiotics: A Synergistic Partnership

Synergy means that the combined effect is greater than the sum of individual effects.

For MRSA treatment, this is potentially game-changing.

Manuka honey may be able to restore the effectiveness of failing antibiotics, reduce the antibiotic doses needed, and help to prevent the development of antibiotic-resistant bacteria.

Reversing antibiotic resistance

The most dramatic finding of the research is that Manuka honey can make MRSA vulnerable to antibiotics that it previously resisted.

A 2012 study found that "manuka honey reversed oxacillin resistance in MRSA, and down-regulation of mecR1 was found in cells treated with manuka honey"¹³.

The mecR1 gene regulates expression of mecA - the gene that makes MRSA resistant to methicillin and related antibiotics.

By downregulating this gene, Manuka honey essentially ‘turned off’ the resistance mechanism.

"Here we demonstrated that subinhibitory concentrations of honey in combination with oxacillin restored oxacillin susceptibility to MRSA," the researchers reported¹³.

This means Manuka honey made MRSA treatable with an antibiotic that previously didn't work against it.

The rifampicin connection

Multiple studies have identified rifampicin as having the strongest synergy with Manuka honey.

This 2013 paper using medical-grade Medihoney found that "Medihoney and rifampicin were strongly synergistic in their ability to reduce both biofilm biomass and the viability of embedded S. aureus cells at a level that is likely to be significant in vivo"¹².

Another 2018 study confirmed the findings: "Rifampicin-manuka honey combinations are superior to other antibiotic-manuka honey combinations in eradicating Staphylococcus aureus biofilms"¹¹.

Why this matters: Rifampicin resistance develops rapidly when the antibiotic is used to treat MRSA on its own. By combining it with Manuka honey, scientists were able to prevent this resistance from emerging - a critical advantage for treating persistent MRSA infections.

No resistance development observed

Across all studies, a consistent finding stands out: bacteria haven't developed resistance to Manuka honey.

"MH's [Manuka honey’s] multiple modes of action may not be easily prone to the development of bacterial resistance... as the concerted actions likely overwhelm the bacterial stress responses"¹⁷.

When bacteria are exposed to single-mechanism antibiotics, they evolve to develop resistance. But Manuka honey attacks through multiple mechanisms at the same time (disrupting cell division, disrupting biofilm formation, gene expression, and affecting metabolic activity).

For bacteria to develop resistance to Manuka honey, they'd likely need to evolve defences against all mechanisms at once.

This is why, despite extensive use and laboratory cultivation under resistance-favouring conditions, no honey-resistant strains have emerged (at the time of writing)