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Antimicrobial activity of a novel bioengineered honey against non-typeable Haemophilus influenzae biofilms: an in vitro study
  1. Rachel S Newby1,
  2. Matthew Dryden2,3,
  3. Raymond N Allan1,4,
  4. Rami J Salib3,5
  1. 1 Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK
  2. 2 Hampshire Hospitals NHS Foundation Trust, Winchester, UK
  3. 3 University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4 Southampton NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  5. 5 Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to Professor Rami J Salib, Faculty of Medicine, Academic Unit of Clinical and Experimental Sciences, Southampton SO16 6YD, UK; R.J.Salib{at}


The opportunistic pathogen non-typeable Haemophilus influenzae (NTHi) plays an important role in many chronic respiratory diseases including otitis media, chronic rhinosinusitis, cystic fibrosis and chronic obstructive pulmonary disease. Biofilm formation has been implicated in NTHi colonisation, persistence of infection and recalcitrance towards antimicrobials. There is therefore a pressing need for the development of novel treatment strategies that are effective against NTHi biofilm-associated diseases. SurgihoneyRO is a honey-based product that has been bioengineered to enable the slow release of H2O2, a reactive oxygen species to which H. influenzae is susceptible. Treatment of established NTHi biofilms with SurgihoneyRO significantly reduced biofilm viability through enhanced H2O2 production and was shown to be more effective than the conventional antibiotic co-amoxiclav.

  • haemophilus spp
  • antimicrobial resistance
  • bacteriology
  • infection control

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  • RNA and RJS contributed equally.

  • Handling editor Tony Mazzulli.

  • Contributors The project was conceived by RJS and RNA. RSN and RNA carried out all acquisition and analysis of data. All authors contributed towards preparation of the manuscript.

  • Competing interests None declared.

  • Ethics approval Southampton and South West Hampshire Research Ethics 06/Q1704/105.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional, unpublished data from this study comprise viability and biomass data for S. aureus biofilms treated with different concentrations of SurgihoneyRO and Acacia and confocal micrograph images of treated S. aureus biofilms. These data are freely available. For information contact