|Honey included in a wound dressing (Source)|
Honey has long been used to stave off the bacterial infection of wounds (due to burns, surgery, or trauma). The wound healing nature of honey is mentioned in texts from ancient Egypt (bees were considered sacred) and Greece (Hippocrates thought honey was great). Honey is particularly interesting because it appears to be active against otherwise drug-resistant bacteria and doesn't become the target of resistance itself. Its ability to prevent and limit the growth of bacteria once applied to a wound stems from four characteristics: (1) high sugar concentration (i.e. low water activity), (2) low pH, (3) slow yet steady hydrogen peroxide production (via glucose oxidase), and (4) unknown flower- or bee-derived antibacterial substances. One of the issues with using honey is the substantial variation among honeys from different natural environments with respect to their ability to kill bacteria. The solution to this has been the development of medical-grade honey manufactured by bees in closed greenhouses (i.e. under controlled conditions) to ensure a more consistent product.
|A thousand-year-old recipe for an antibacterial salve (Source)|
A 10th century English (Anglo-Saxon) medical textbook (entitled Bald’s Leechbook) recently yielded a recipe for an antibacterial ointment capable of offing MRSA, a widespread drug-resistant form of Staphylococcus aureus. Bald’s eyesalve was indicated for treating a “wen” in the eye. This is probably a reference to a sty, an infection of the eyelid typically caused by S. aureus. The recipe calls for garlic and another close garlic relative (the text isn't clear on which one, both onion and leek worked in the modern preparation). These were to be crushed, mixed with wine and ox gall (cow bile), and stored in a brass or bronze container for just over a week. Notably, all of the ingredients on their own (except the wine) are thought to have some antibacterial activity. Further, some of the copper (an excellent bacteria killer) from the container (brass and bronze are both copper alloys) likely leached into the salve during its storage.
In Jordan, there's a long history of using red soils to treat skin infections. The soil is collected from beneath the surface and away from where people congregate, and applied daily as a paste or powder to the infected area. It's now known the soil contains several bacteria capable of making antibacterial compounds.
To close things out, it's worth noting antibacterial use in the pre-penicillin era wasn't always intentional. If you shine a UV light on the skeletal remains of people who lived in Sudanese Nubia or near the Dakhleh Oasis in Egypt during the 4th to 6th centuries, chances are they'll produce a yellow-green glow. This is because the skeleton-wearers were exposed to tetracycline during their lives. Tetracycline is an antibacterial drug produced by certain bacteria (Streptomyces species) that likes to hang out with calcium and so ends up accumulating in bone and teeth. It appears the folks with the glowing skeletons inadvertently consumed food, probably stored grains, contaminated with tetracycline-producing bacteria. This intake may have had a beneficial effect, as the Sudanese Nubian population apparently wasn't prone to infectious diseases (based on records from the time) and the bones recovered from the Dakhleh Oasis didn't show any signs of infection (e.g. bone destruction due to leprosy).
Aminov RI. 2010. A brief history of the antibiotic era: Lessons learned and challenges for the future. Frontiers in Microbiology 1:134. [Full text]
Falkinham JO 3rd, Wall TE, Tanner JR, Tawaha K, Alali FQ, Li C, Oberlies NH. 2009. Proliferation of antibiotic-producing bacteria and concomitant antibiotic production as the basis for the antibiotic activity of Jordan's red soils. Applied and Environmental Microbiology 75(9):2735-2741. [Full text]
Goodman L, Gilman A. 1941. The pharmacological basis of therapeutics. Macmillan Company.
Harrison F, Roberts AE, Gabrilska R, Rumbaugh KP, Lee C, Diggle SP. 2015. A 1,000-year-old antimicrobial remedy with antistaphylococcal activity. mBio 6(4):e01129-15. [Full text]
Jacobsen PL, Levy L. 1973. Mechanism by which hydnocarpic acid inhibits mycobacterial multiplication. Antimicrobial Agents and Chemotherapy 3(3):373-379. [Full text]
Kwakman PH, Van den Akker JP, Güçlü A, Aslami H, Binnekade JM, de Boer L, Boszhard L, Paulus F, Middelhoek P, te Velde AA, Vandenbroucke-Grauls CM, Schultz MJ, Zaat SA. 2008. Medical-grade honey kills antibiotic-resistant bacteria in vitro and eradicates skin colonization. Clinical Infectious Diseases 46(11):1677-1682. [Full text]
Lee DS, Sinno S, Khachemoune A. 2011. Honey and wound healing: An overview. American Journal of Clinical Dermatology 12(3):181-190. [First two pages]
Stermitz FR, Lorenz P, Tawara JN, Zenewicz LA, Lewis K. 2000. Synergy in a medicinal plant: Antimicrobial action of berberine potentiated by 5'-methoxyhydnocarpin, a multidrug pump inhibitor. PNAS 97(4):1433-1437. [Full text]