Formulation of an antibacterial topical cream containing bioengineered honey that generates reactive oxygen species

SurgihoneyRO™ (SHRO) is a bioengineered medicinal honey proven to eradicate multi-drug resistant strains of bacteria by delivering a controlled dose of reactive oxygen species (ROS). The urgent need for novel antimicrobial therapies capable of tackling pathogens that have developed resitance to existing antimicrobial medicines, such as antibiotics, makes SHRO a highly desirable biomaterial. However, its application is currently limited in the medical field due to undesirable material properties. This study aims to formulate the honey into a clinically viable topical cream whilst maintaining antimicrobial efficacy. SHRO droplets were emulsified to protect the active until activation in-situ. Xanthan gum (XG) and fumed silica (FS) thickener systems were explored, with both formulations able to inhibit the growth of S. aureus in-vitro. However, FS formulations exhibited significantly higher hydrogen peroxide release over a period of 7 days and resulted in larger zones of inhibition (42%) than XG formulations. Selection of the optimum FS formulation was made based on evaluation of the material characteristics by means of rheology and texture analysis. In place of the sticky and highly viscous initial SHRO product, desirable material characteristics for a topical product were achieved, including thixotropic shear-thinning behaviour and significantly lower cohesiveness (15.3-22.4 N) than standard SHRO formulations (79.9 N). Furthermore, the product exhibited a low contact angle on porcine skin, indicating that these formulations would spread favourably on the skin surface, demonstrate a favourable sensory perception and be retained on the skin, making for a more clinically effective product. This work is the first report of an engineered cream system to controllably deliver ROS to a wound site and demonstrate its ability of eradicating clinically relevant bacteria in vitro.