Punitan , S. Rajendran
(2016)
Clinical and antibacterial effect of tualang honey on pseudomonas keratitis in rabbit eyes.
Masters thesis, Universiti Sains Malaysia.
Abstract
BACKGROUND
Pseudomonas aeruginosa is a common cause of microbial keratitis that can be sufficiently
severe to cause a significant loss in visual acuity. Fluoroquinolones and aminoglycosides
have a well-recognized clinical effectiveness against Pseudomonas-induced keratitis. As
resistant pathogens are becoming more potent nowadays, the effectiveness of these
antibiotics are reduced conspicuously. Tualang honey is produced by the rock bee (Apis
dorsata), which builds hives high up in the branches of the tualang tree (Kompassia
excelsa or Mengaris). It is used commonly as medicinal product and food in Malaysia.
Tualang honey has both bactericidal and bacteriostatic properties against a wide range of
bacteria. Besides that, it has anti-inflammatory and antioxidant properties which can
facilitate wound healing. The potency of tualang honey against microorganisms suggest
its potential to be used as an alternative therapeutic agent for certain medical conditions
especially wound infection.
OBJECTIVE
To evaluate the clinical response and antibacterial effect of tualang honey as an alternative
therapeutic agent in Pseudomonas-induced keratitis in rabbit eyes.
METHOD
An experimental randomized control trial in bacterial keratitis was performed in rabbit
eyes between September 2014 and September 2016. A total of 30 rabbits' corneas were
injected intrastromally with 1,000 colony forming units (CFU) of Pseudomonas
aeruginosa in each eye. Twenty-four hours after the injection, the rabbits were
randomised into three groups consisting of 10 rabbits in each group. Group A was treated
with topical gentamicin 0.3%, Group B with topical tualang honey 30%, and Group C
with combination of topical gentamicin 0.3% and tualang honey 30%. Topical antibiotics
were then administered every 2 hours for the first 24 hours in all three groups.
Subsequently, the medications were administered every 4 hours for 6 days. Clinical
examination and mean slit lamp examination (SLE) of rabbits’ eyes were documented at
day 1, 2, 3, 5 and 7 post induction of Pseudomonas aeruginosa. The eyes of each group
were examined and recorded clinically using ulcer scoring system for corneal infiltrate,
corneal ulcer, hypopyon and corneal perforation. At day 7 post induction of Pseudomonas
aeruginosa, rabbits were euthanized and corneas were harvested to determine the mean
CFU per cornea.
The data collected were analyzed using Statistical Package for Social Science (SPSS)
software version 22. Repeated measure ANOVA with multivariate analysis of variance
were used for statistical analysis. For the data that was not normally distributed, Kruskal
Wallis test was used. Thus the values were expressed as median (interquartile range). The
p value of < 0.05 is considered statistically significant.
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