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Among honey types, Manuka honey, rich in methylglyoxal, and citrus honey, abundant in flavonoids and bioactive enzymes, exhibit potent antimicrobial activity. This study aims to enhance the antimicrobial and antibiofilm efficacy of Manuka and citrus honey by incorporating natural additives\u2014aloe vera, Indian costus, and mint essential oil\u2014into cream formulations. Two emulsion types, aerosil fumed silica-based and arabic gum-based, were prepared and optimized using sonication. The antimicrobial activity of these formulations was assessed against pathogenic bacteria, including <jats:italic>Bacillus cereus<\/jats:italic>, <jats:italic>Pseudomonas aeruginosa<\/jats:italic>, <jats:italic>Salmonella enterica<\/jats:italic> subsp. <jats:italic>enterica<\/jats:italic> serovar Typhimurium, Methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic>, <jats:italic>Listeria monocytogenes<\/jats:italic>, <jats:italic>Micrococcus luteus<\/jats:italic>,<jats:italic> Escherichia coli<\/jats:italic> O157:H7, and <jats:italic>Klebsiella pneumoniae<\/jats:italic>, as well as fungi such as <jats:italic>Candida albicans<\/jats:italic> and <jats:italic>Aspergillus niger<\/jats:italic>. The most effective formulations demonstrated inhibition zones of up to 28\u00a0mm against <jats:italic>B. cereus<\/jats:italic> and 24\u00a0mm against <jats:italic>S.<\/jats:italic> Typhimurium. Additionally, antibiofilm activity was evaluated using a 3D biofilm model, with formulations containing citrus honey and Indian costus or Manuka honey and aloe vera achieving biofilm reductions of 44.39% and 21.33%, respectively, against <jats:italic>P. aeruginosa<\/jats:italic> and MRSA. Furthermore, the composition of the citrus honey was analyzed using gas chromatography-mass spectrometry to identify the volatile and non-volatile compounds contributing to their antimicrobial properties. These findings suggest that honey-based formulations enhanced with natural additives hold significant potential for combating biofilm-associated infections.<\/jats:p>","DOI":"10.1038\/s41598-025-90072-6","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T13:56:13Z","timestamp":1741010173000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Formulation and evaluation of therapeutic antimicrobial citrus and Manuka honey creams with aloe vera, mint essential oil, and Indian costus"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3685-6859","authenticated-orcid":false,"given":"Marwa N.","family":"Ahmed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omnia A.","family":"Elnasser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Farghali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ossama A.","family":"Ibrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala R.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olfat S.","family":"Barakat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"issue":"2","key":"90072_CR1","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1016\/j.idc.2016.02.001","volume":"30","author":"RR Watkins","year":"2016","unstructured":"Watkins, R. 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