Honeybee health is a key factor in sustainable apiculture, with the most significant colony losses attributed to the mite Varroa destructor and microsporidia of the genus Nosema spp. The aim of this review article is to summarise current knowledge on the use of pharmaceuticals and preparations in the prevention and treatment of these diseases and to highlight promising alternatives to synthetic acaricides. Commonly used active substances such as amitraz and pyrethroids show decreased efficacy in many countries due to the development of resistance. Therefore, organic acids (formic, oxalic, and lactic), essential oils, and plant extracts are increasingly used as environmentally friendly, residue-free alternatives. Some plant preparations and extracts have been shown to be effective against Nosema ceranae. In addition to therapeutic interventions, the importance of preventive measures and immune support through supplements containing vitamins, amino acids, and probiotics is emphasised. The article highlights the need for integrated bee health management combining pharmacological, natural, and biotechnological approaches to limit resistance development, minimise residues in bee products, and promote overall colony vitality.
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