Honey is more effective and less harmful than usual care for improving symptoms of upper respiratory tract infections, particularly cough frequency and cough severity, according to a systematic review and meta-analysis of previous studies, published in the journal BMJ Evidence Based Medicine.
Upper respiratory tract infections are the most frequent reason for antibiotic prescription.
Since the majority of these infections are viral, antibiotic prescription is both ineffective and inappropriate.
However, a lack of effective alternatives and a desire to preserve the patient-doctor relationship both contribute to antibiotic over prescription.
“Honey is a well known traditional therapy for symptoms of upper respiratory tract infections,” said lead author Hibatullah Abuelgasim from the Oxford University Medical School and colleagues.
“Guidelines recommend it for acute cough in children but the evidence base for honey use for other upper respiratory tract infections symptoms and populations has not been evaluated.”
“We therefore systematically reviewed the use of honey for the resolution of symptoms associated with these infections, in patients of all ages, in any setting.”
Abuelgasim and University of Oxford’s Nuffield Department of Primary Care Health Sciences researchers Charlotte Albury and Joseph Lee analyzed studies that compared the effect of taking honey (in forms such as teas, neat, or mixed with other ingredients) to either usual care (such as antibiotics, or over-the-counter cough syrups and medications) or placebos.
They included 14 studies in their analysis, all of which were randomised controlled trials.
They found that, compared to usual care, honey was associated with a significantly greater reduction in symptoms, specifically cough severity and frequency.
“Honey has long been known as a traditional treatment for symptoms of upper respiratory tract infections, such as coughs and sore throat,” Dr. Lee said.
“Since 2018 the National Institute for Health and Care Excellence (NICE) and Public Health England (PHE) have recommend the use of honey to treat the symptoms of acute coughs in adults and children five years or older.”
“However, this is based on a review of just three randomised controlled trials. Our work adds to this evidence base and focuses specifically on upper respiratory tract infections.”
“Doctors often prescribe antibiotics for upper respiratory tract infections, even when they could be fairly certain they might offer no clinical benefit, often due to a lack of alternative treatments and an earnest desire to help patients feel better,” Dr. Albury said.
“This research gives us good quality evidence that can help doctors be confident when suggesting people use honey.”
“Honey is cheap and widely available, many people will probably have some sitting in the cupboard anyway, so it’s worth giving it a try before visiting your GP,” Dr. Lee said.
“Of course, if symptoms are getting worse, or you feel very unwell, then contact your GP.”