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Honey is better than usual care for easing upper respiratory tract symptoms, especially cough, according to a review by UK researchers.
The study authors from Oxford University found that honey was “superior” to usual care for the improvement of symptoms of upper respiratory tract infections (URTI).
“When clinicians wish to prescribe for URTI, we would recommend honey as an alternative to antibiotics”
Usual care was mostly antihistamines, expectorants, cough suppressants, and painkillers, noted the researchers in their study published in the journal BMJ Evidence Based Medicine.
They highlighted it provided a “widely available and cheap alternative to antibiotics” and suggested it could potentially help efforts to slow the spread of antimicrobial resistance.
They also noted that honey was a well-known traditional therapy for URTI symptoms and had been recommended in a Cochrane review for acute cough in children.
It was also backed by the National Institute for Health and Care Excellence in a series of guidelines developed with Public Health England to try and tackle the over-prescribing of antibiotics.
NICE said in the guidance, published in 2018, that honey or over-the-counter cough medicines should be the first port of call for people with acute cough.
The NICE committee reviewed a range of remedies and identified a limited number of substances – including honey – with some evidence to show they could help alleviate acute cough symptoms.
However, the authors of the new study said the evidence base for using honey for URTI symptoms other than in children was still “emerging” and that it had not previously been evaluated.
As a result, the researchers looked for relevant studies comparing honey and preparations that included it as an ingredient with usual care.
“Honey was associated with a significantly greater reduction in combined symptom score, cough frequency and cough severity”
They found 14 suitable trials, involving 1,761 participants. Analysis showed honey was more effective than usual care for improving symptoms, especially the frequency and severity of coughing.
In fact, two of the studies showed that symptoms lasted one to two days fewer among those treated with honey, said the researchers.
In their journal article, the authors stated: “In comparison with usual care, honey was associated with a significantly greater reduction in combined symptom score, cough frequency and cough severity.”
Honey might, therefore, provide an alternative when clinicians want to recommend or prescribe something to safely treat upper respiratory tract symptoms, they suggest.
“When clinicians wish to prescribe for URTI, we would recommend honey as an alternative to antibiotics,” they said.
“Honey is a frequently used lay remedy that is well known to patients. It is also cheap, easy to access, and has limited harms.”
They added: “[It] is more effective and less harmful than usual care alternatives and avoids causing harm through antimicrobial resistance.”
However, the researchers cautioned that honey was a complex substance and not a uniform product, and only two of the studies involved a placebo.
“Because of the limitations to the evidence, particularly for adults, we would support large, high quality placebo controlled trials,” they said.