Systematic Review
Volume 18 Issue 8 - 2022
A Scoping Review: Efficacy of Medical-Grade Honey as an Alternative Therapy against Vulvovaginal Candidiasis
Ahmad Aliyu1* and Aminat Aliyu2
1Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Niger State, Nigeria
2School of Remedial and Continuing Education, A.D Rufa’i College of Education, Legal and General Studies, Misau, Bauchi State, Nigeria
*Corresponding Author: Ahmad Aliyu, Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Niger State, Nigeria.
Received: May 04, 2022; Published: July 11, 2022


Background: The emerging of non-albicans Candida species and Candida species have becoming potential clinical pertinence among numerous patients with vulvovaginal candidiasis. Routine treatment option include fluconazole as a primary therapeutic choice for the management of both recurrent and vulvovaginal candidiasis. However, concomitant increase in both acquired and inherent resistance of fluconazole against the diseases have been reported. Medical-Grade Honey has immunomodulatory, protective and antimicrobial activity that constitutes a reputed alternative treatment against Candida species mediated vaginal infections.

Aim: This study examined the efficacy of Medical-Grade Honey against vulvovaginal candidiasis compared to fluconazole therapy.

Method: This study examines the in vitro studies of the potency of Medical-Grade Honey against vulvovaginal candidiasis.

Results: The study showed that Medical-Grade Honey is more effective against vulvovaginal candidiasis compared to fluconazole that have positive effect on Candida species and antimicrobial activity. The synopsis of in vitro studies evaluating the antimicrobial activity of Medical-Grade Honey against Candida species showed that Candida albicans had the highest percentage frequency of 34.48% (10.00). The rate of antimicrobial activity of the substrate on different clinical isolates revealed that the substrate 8 (Local produced honey) have potential antimicrobial activity on Candida albicans, Candida tropicalis, Candida glabrata, Candida krusei, Candida kefyr and Candida dubliniensis with the percentage frequency of 20.69% (6.00). The lower limit of Minimum Inhibitory Concentration (MIC) value of different substrates revealed that the substrates 6 (Monofloral lavender honey) had the lowest MIC value with percentage frequency of 4.65% (16.00). The upper limit of MIC value of different substrates revealed that the substrate 5 (Honey and Miconazole) had the highest MIC value with percentage frequency of 14.78% (80.00).

Conclusion: From the reported in vitro studies, Medical-Grade Honey especially Monofloral Lavender Honey can be used against vulvovaginal candidiasis due to present of high fluconazole resistance rate issues. Monofloral Lavender Honey inhibit the growth of all Candida species and has the lowest minimum inhibitory concentration (MIC) which indicated that the honey is more effective as antifungal agents against the disease. Medical-Grade Honey has proven the effectiveness of immunomodulatory, protective, antimicrobial activity and can serve as alternative therapy against vulvovaginal candidiasis. This study suggest further in vivo analysis to confirm the effectiveness of Medical-Grade Honey against the disease.


Keywords: Candida Species; Fluconazole; Vulvovaginal Candidiasis; In Vitro Studies; Medical-Grade Honey; In Vivo Analysis


  1. Yilmaz AC., et al. “Honey Dressing in Wound Treatment: A Systematic Review”. Complementary Therapies in Medicine2 (2020): 102388.
  2. Jahdi F., et al. “Vulvovaginal Candidiasis Symptom Reduction Honey, Yogurt-and-Honey and Clotrimazole Vaginal Cream - A Triple Blind Randomized Control Trial”. Journal of Evolution of Medical and Dental Sciences08 (2021): 515-521.
  3. Ahangari F., et al. “Comparing the effectiveness of Salvia officinalis, clotrimazole and their combination on vulvovaginal candidiasis: a randomized, controlled clinical trial”. Journal of Obstetrics and Gynaecology Research4 (2019): 897-907.
  4. Willems HME., et al. “Vulvovaginal candidiasis: a current understanding and burning questions”. Journal of Fungi 1 (2020): 27.
  5. Sobel JD. “Recurrent vulvovaginal candidiasis”. American Journal of Obstetrics and Gynecology 214 (2016): 15-21.
  6. Denning DW. “Global burden of recurrent vulvovaginal candidiasis: A systematic review”. The Lancet Infectious Disease 18 (2018): e339-e347.
  7. Hermanns R., et al. “Sweet relief: determining the antimicrobial activity of medical grade honey against vaginal isolates of Candida albicans”. Journal of Fungi 3 (2019): 85.
  8. Tehrani FR., et al. “Prevalence of vaginitis in Iranian women--symptoms and clinical association”. Medical Science Journal of Islamic Azad University Tehran Medical Branch1 (2012): 62-68.
  9. Lopez JEM. “Candidiasis (vulvovaginal)”. The BMJ Clinical Evidence (2015): 0815.
  10. Yan L., et al. “Antifungal susceptibility profile of Candida albicans isolated from vulvovaginal candidiasis in Xinjiang province of China”. Mycopathologia3 (2019): 413-422.
  11. Farhan MA., et al. “Types of yeasts that cause vulvovaginal candidiasis in chronic users of corticosteroids”. Medical Mycology6 (2019): 681-687.
  12. Azike CA., et al. “Molecular characterization and phylogeny of Candida species isolated from high vaginal swab samples among patients presenting with vulvovaginal candidiasis in Port Harcourt, Nigeria”. European Journal of Biomedical and Pharmaceutical Sciences7 (2018): 83-89.
  13. Eteraf-Oskouei T. and Najafi M. “Traditional and modern uses of natural honey in human diseases: a review”. Iranian Journal of Basic Medical Sciences6 (2013): 731-742.
  14. Vallianou NG., et al. “Honey and its anti-inflammatory, anti-bacterial and anti-oxidant properties”. General Medicine 2 (2014): 1-5.
  15. Aboushady RMN., et al. “Sider honey Vs. fluconazole and the cure rate of vulvovaginal candidiasis. IOSR Journal of Nursing and Health Science”. IOSR-Journal of Nursing and Health Science 4 (2015).
  16. Rosati D., et al. “Recurrent Vulvovaginal Candidiasis: An Immunological Perspective”. Microorganisms 8 (2020): 144.
  17. Cooper H. “Research Synthesis and Meta-Analysis: A Step-by-Step Approach”. SAGE, Thousand Oaks, Calif, USA, 4th edition (2009).
  18. Moher D., et al. “Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement”. Annals of Internal Medicine 151 (2009): 264-269.
  19. Riel VMJJS., et al. “Treating (Reccurent) Vulvovaginal Candidiasis with Medical-Grade Honey - Concepts and Practical Considerations”. Journal of Fungi664 (2021): 1-18.
  20. Fernandes L., et al. “Portuguese honeys as antimicrobial agents against Candida species”. Journal of Traditional Complementary Medicine and Therapies 11 (2021): 130-136.
  21. Shokri H. and Sharifzadeh A. “Fungicidal efficacy of various honeys against fluconazole-resistant Candida species isolated from HIV(+) patients with candidiasis”. Journal of Medical Mycology 27 (2017): 159-165.
  22. Ansari MJ., et al. “Effect of jujube honey on Candida albicans growth and biofilm formation”. Archives of Medical Research 44 (2013): 352-360.
  23. Banaeian-Borujeni S., et al. “Comparison of the effect of honey and miconazole against Candida albicans In vitro”. Advanced Biomedical Research 2 (2013): 57.
  24. Estevinho ML., et al. “Antifungal effect of lavender honey against Candida albicans, Candida krusei and Cryptococcus neoformans”. Journal of Food Science and Technology 48 (2011): 640-643.
  25. Koc AN., et al. “Antifungal activity of Turkish honey against Candida and Trichosporon spp: An In vitro evaluation”. Medical Mycology 47 (2009): 707-712.
  26. Khosravi AR., et al. “Fungicidal potential of different Iranian honeys against some pathogenic Candida species”. Journal of Apiculture Research 47 (2008): 256-260.
  27. Irish J., et al. “Honey has an antifungal effect against Candida species”. Medical Mycology 44 (2006): 289-291.
  28. Al-Waili NS. “Mixture of honey, beeswax and olive oil inhibits growth of Staphylococcus aureus and Candida albicans”. Archives of Medical Research 36 (2005): 10-13.
  29. Vediyappan G., et al. “Interaction of Candida albicans biofilms with antifungals: Transcriptional response and binding of antifungals to beta-glucans”. Antimicrobial Agents and Chemotherapy 54 (2010): 2096-2111.
  30. Zangl I., et al. “The role of Lactobacillus species in the control of Candida via biotrophic interactions”. Microbial Cell 7 (2019): 1-14.
  31. Hermanns R., et al. “Defining the standards for medical grade honey”. Journal of Apiculture Research 59 (2020): 125-135.
  32. Emineke S., et al. “Diluted honey inhibits biofilm formation: Potential application in urinary catheter management”. Journal of Clinical Pathology 70 (2017): 140-144.
  33. Nair HKR., et al. “Medical-Grade Honey Kills Antibiotic-Resistant Bacteria and Prevents Amputation in Diabetics with Infected Ulcers: A Prospective Case Series”. Antibiotics 9 (2020): 529.
  34. Cavalheiro M. and Teixeira MC. “Candida Biofilms: Threats, Challenges, and Promising Strategies”. Frontiers in Medicine 5 (2018): 28.
  35. Deorukhkar SC., et al. “Non-albicans Candida Infection: An Emerging Threat”. Interdisciplinary Perspectives on Infectious Diseases (2014): 615958.
  36. Shamala TR. et al. “Stimulatory effect of honey on multiplication of lactic acid bacteria under In vitro and In vivo conditions”. Letters in Applied Microbiology 30 (2000): 453-455.
  37. Samarghandian S., et al. “Honey and Health: A Review of Recent Clinical Research”. Pharmacognosy Research 9 (2017): 121-127.
  38. Sokol CL. and Luster AD. “The chemokine system in innate immunity”. Cold Spring Harbor Perspectives in Biology (2015): 7.
  39. Miguel MG., et al. “Honey as a Complementary Medicine”. Integrative Medicine Insights 12 (2017): 1178633717702869.
  40. Gasparrini M., et al. “Protective effects of Manuka honey on LPS-treated RAW 264.7 macrophages. Part 2: Control of oxidative stress induced damage, increase of antioxidant enzyme activities and attenuation of inflammation”. Food and Chemical Toxicology 120 (2018): 578-587.
  41. Mandel HH., et al. “Intralesional application of medical grade honey improves healing of surgically treated lacerations in horses”. Equine Veterinary Journal 52 (2020): 41-45.
  42. Cremers N., et al. “In vitro antimicrobial efficacy of two medical grade honey formulations against common high-risk methicillin-resistant Staphylococci and Pseudomonas Pathogens”. Veterinary Dermatology 31 (2020): 90-96.
  43. Pleeging CCF., et al. “Synergistic Antimicrobial Activity of Supplemented Medical-Grade Honey against Pseudomonas aeruginosa Biofilm Formation and Eradication”. Antibiotics 9 (2020): 866.
  44. Berkow LE and Lockhart RS. “Fluconazole resistance in Candida species: a current perspective”. Infection and Drug Resistance 10 (2017): 237-245.
  45. Gharibi TM., et al. “Comparison of combined use of fluconazole and clotrimazole with the sequential dose of fluconazole in the treatment of recurrent Candida vaginitis”. Iranian South Medical Journal1 (2009): 34-39.
  46. Pfaller MA., et al. “Isavuconazole, micafungin, and 8 comparator antifungal agents’ susceptibility profiles for common and uncommon opportunistic fungi collected in 2013: temporal analysis of antifungal drug resistance using CLSI species-specific clinical breakpoints and proposed epidemiological cutoff values”. Diagnostic Microbiology and Infectious Disease4 (2015): 303-313.
  47. Calderone RA. and Clancy CJ. “Candida and Candidiasis”. American Society of Microbiology (2012).
  48. Waykar B. and Alqadhi AY. “Beekeeping and Bee products; Boon for Human Health and Wealth”. Indian Journal of Pharmaceutical and Biological Research3 (2016): 20-27.
  49. Fazel N., et al. “Comparison of honey with clotrimazole alone and mixed on candidial vaginitis”. Iranian Journal of Obstetrics Gynecology and Infertility8 (2011): 48-54.
  50. Hegazi AG. and Abd El-Hady FK. “Influence of honey on the suppression of human low density lipoprotein (LDL) peroxidation (In vitro)”. Evidence-based Complementary and Alternative Medicine 6 (2009): 113-121.
  51. Behmanesh F., et al. “Antifungal effect of Lavender essential oil (Lavandula angustifolia) and clotrimazole on Candida albicans: An In vitro Study”. Scientifica 261397 (2015): 1-7.
  52. D’Auria FD., et al. “Antifungal activity of Lavandula angustifolia essential oil against Candida albicans yeast and mycelial form”. Medical Mycology5 (2005): 391-396.
  53. Ehrstrom S., et al. “Lactic acid bacteria colonization and clinical outcome after probiotic supplementation in conventionally treated bacterial vaginosis and vulvovaginal candidiasis”. Microbes and Infection1 (2010): 691-699.
  54. Minden-Birkenmaier AD., et al. “The effect of Manuka Honey on Dhl-60 cytokine, chemokine, and matrix-degrading enzyme release under inflammatory conditions”. Medicine One2 (2019): 1-21.
  55. Alvarez-Suarez JM., et al. “Activation of AMPK/Nrf2 signalling by Manuka honey protects human dermal fibroblasts against oxidative damage by improving antioxidant response and mitochondrial function promoting wound healing”. Journal of Functional Foods 25 (2016): 38-49.
  56. Liu TM., et al. “Prophylactic and therapeutic effects of honey on radiochemotherapy-induced mucositis: A meta-analysis of randomized controlled trials”. Supportive Care in Cancer 27 (2019): 2361-2370.
  57. Aboushady NMR., et al. “Sider honey Vs. fluconazole and the cure rate of vulvovaginal candidiasis”. Journal of Nursing and Health Science 3 (2015): 05-14.
  58. Cater AD., et al. “Therapeutic Manuka honey: No longer so alternative”. Frontiers in Microbiology569 (2016): 1-11.
  59. Peyton RL., et al. “Triazole antifungals: A review”. Drugs of Today12 (2015): 705-718.
  60. Mahl DC., et al. “Induction of ROS generation by fluconazole in Candida glabrata: activation of antioxidant enzymes and oxidative DNA damage”. Diagnostic Microbiology and infectious Disease3 (2015): 203-208.
  61. Steel CH., et al. “Comparison of the anti-inflammatory activities of imidazole antimycotics in relation to molecular structure”. Chemical Biology and Drug Design.3 (2008): 225-228.
Citation: Ahmad Aliyu and Aminat Aliyu. “A Scoping Review: Efficacy of Medical-Grade Honey as an Alternative Therapy against Vulvovaginal Candidiasis”. EC Microbiology 18.8 (2022): 08-24.

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