Activity of Stingless Bee Honey (Heterotrigona itama) Hydrogel Against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa

Diabetic foot ulcers (DFUs), a prevalent and debilitating complication of diabetes mellitus (DM), are commonly exacerbated by polymicrobial infections involving pathogens. Recent investigations have highlighted the therapeutic potential of stingless bee honey (SBH) derived from Heterotrigona itama, which exhibits significant antibacterial activity attributed to its bioactive constituents. This study aimed to evaluate and compare the antibacterial efficacy of 20% and 25% SBH-based hydrogels against Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa by analyzing inhibition zone diameters. A posttest-only controlled experimental design was employed. The test groups consisted of 20% and 25% SBH hydrogels, Cutimed® gel as the positive control, and sterile distilled water as the negative control. Antibacterial activity was statistically evaluated using one-way analysis of variance (ANOVA), with subsequent application of Duncan's post hoc test to determine significant differences among experimental groups. Significant differences in inhibition zones were observed among treatments (p < 0.001). The 25% honey hydrogel demonstrated the largest mean inhibition zones against all tested bacterial strains, surpassing those of the 20% formulation, the negative control, and Cutimed® gel. SBH hydrogel exhibits concentration-dependent antibacterial activity, with the 25% concentration displaying superior antibacterial effects. These findings underscore its potential as a natural therapeutic agent for managing diabetic foot ulcers, warranting further clinical investigation.