Honey Prophylaxis Reduces the Risk of Endophthalmitis During Perioperative Period of Eye Surgery

Endophthalmitis following eye surgery remains a rare but serious complication. Topical fluoroquinolones have been used as prophylactic agents against endophthalmitis. However, the emerging resistance of ocular pathogens to fluoroquinolones may preclude their routine use. Honey, a natural antimicrobial product with wound healing properties, is a promising candidate for the prophylaxis of endophthalmitis. The goal of this study was to determine whether 25% (w/v) honey solution is effective in eradicating bacterial ocular pathogens in the perioperative period in patients scheduled for cataract surgery or vitrectomy, and to compare its efficacy to 0.3% ofloxacin. In this pilot study, 101 patients were randomized to honey (n?=?49) or ofloxacin (n?=?52) treatment. In both groups, eye drops were administered five times a day for 7?days before and 5?days after surgery. Before administration of the antibacterial agents, 18 and 25 isolates were detected in the ofloxacin and honey group, respectively. After 7?days of administration, four isolates (coagulase-negative Staphylococcus) were detected in each therapeutic group. No significant difference in antibacterial effect was found between groups. These results indicate that honey may act as a prophylactic agent of endophthalmitis; however, further studies are needed to characterize its ocular penetration properties. Copyright (C) 2011 John Wiley & Sons, Ltd.