Insights & Discussion
Moderate‐certainty evidence showed that honey probably reduces cough duration to a greater extent than salbutamol or placebo. Honey group participants were first to get total relief of cough compared to salbutamol or placebo.
Honey probably relieves cough symptoms to a greater extent than no treatment, diphenhydramine, and placebo, but may make little or no difference compared to dextromethorphan. Honey probably reduces cough duration better than placebo and salbutamol. There was no strong evidence for or against using honey. Most of the children received treatment for one night, which is a limitation to the results of this review. There was no difference in occurrence of adverse events between the honey and control arms.
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Honey is more effective than usual care alternatives for improving upper respiratory tract infection symptoms, particularly cough frequency and cough severity.
2020 BMJ Evidence-Based Medicine Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis Abuelgasim H, Albury C, Lee J
Systematic Review Antimicrobial Antimicrobial Resistance Cough
We identified 1345 unique records, and 14 studies were included. Overall risk of bias was moderate. Compared with usual care, honey improved combined symptom score, cough frequency. We combined two studies comparing honey with placebo for relieving combined symptoms.
Honey was superior to usual care for the improvement of symptoms of upper respiratory tract infections. It provides a widely available and cheap alternative to antibiotics. Honey could help efforts to slow the spread of antimicrobial resistance, but further high quality, placebo controlled trials are needed.
Honey can be used as an alternative to antibiotics by clinicians who wish to offer treatment for upper respiratory tract infections, which may help to combat antimicrobial resistance.
2020 BMJ Evidence-Based Medicine Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis Abuelgasim H, Albury C, Lee J
Systematic Review Antimicrobial Antimicrobial Resistance Cough
Upper respiratory tract infections (URTIs) are the most frequent reason for antibiotic prescription. Since the majority of URTIs are viral, antibiotic prescription is both ineffective and inappropriate. However, a lack of effective alternatives, as well as a desire to preserve the patient–doctor relationship, both contribute to antibiotic over prescription. Antibiotic overuse is a key driver of antimicrobial resistance, rated by the UK government as one of the top 10 risks facing Britain. Furthermore, drug resistant infections are associated with worse patient outcomes than antibiotic susceptible infections, underlining the impact of antimicrobial resistance on individual patients.
Milk and honey mixture seems to be at least as effective as dextromethorphan and levodropropizine, the most prescribed over-the-counter antitussives in Italy, in non-specific acute cough in children.
2015 Allergologia et Immunopathologia Effect of multiple honey doses on non-specific acute cough in children. An open randomised study and literature review Miceli Sopo S, Greco M, Monaco S, Varrasi G, Di Lorenzo G, Simeone G
Review Article Cough Honey Non-specific Acute Cough
Honey is recommended for non-specific acute paediatric cough by the Australian guidelines. Current available randomised clinical trials evaluated the effects of a single evening dose of honey, but multiple doses outcomes have never been studied.
134 children suffering from non-specific acute cough were randomised to receive for three subsequent evenings a mixture of milk (90 ml) and wildflower honey (10 ml) or a dose of DM or LDP adjusted for the specific age. The effectiveness was evaluated by a cough questionnaire answered by parents. Primary end-point efficacy was therapeutic success. The latter was defined as a decrease in cough questionnaire score greater than 50% after treatment compared with baseline values.
Three children were excluded from the study, as their parents did not complete the questionnaire. Therapeutic success was achieved by 80% in the honey and milk group and 87% in OTC medication group (p = 0.25).
Honey, in general, and particularly manuka honey, has potent inhibitory activity against the influenza virus, demonstrating a potential medicinal value.
2014 Archives of Medical Research Anti-influenza Viral Effects of Honey In Vitro: Potent High Activity of Manuka Honey Watanabe K, Rahmasari R, Matsunaga A, Haruyama T, Kobayashi N
Network Pharmacology Antiviral Honey Influenza
Antiviral activities of honey samples were evaluated using MDCK cells. To elucidate the possible mechanism of action of honey, plaque inhibition assays were used. Synergistic effects of honey with known anti-influenza virus drugs such as zanamivir or oseltamivir were tested.
Manuka honey efficiently inhibited influenza virus replication (IC50 = 3.6 ± 1.2 mg/mL; CC50 = 82.3 ± 2.2 mg/mL; selective index = 22.9), which is related to its virucidal effects. In the presence of 3.13 mg/mL manuka honey, the IC50 of zanamivir or oseltamivir was reduced to nearly 1/1000th of their single use.
Manuka honey exhibits significant anti-influenza viral activity, inhibiting replication with virucidal effects. Combining manuka honey with existing drugs enhances their efficacy, suggesting its medicinal potential.
2014 Archives of Medical Research Anti-influenza Viral Effects of Honey In Vitro: Potent High Activity of Manuka Honey Watanabe K, Rahmasari R, Matsunaga A, Haruyama T, Kobayashi N
Network Pharmacology Antiviral Honey Influenza
This study aimed to address the urgent need for novel anti-influenza drugs by evaluating the anti-viral activity of honey, focusing on manuka honey. Antiviral activities were assessed using MDCK cells, revealing that manuka honey efficiently inhibited influenza virus replication with an IC50 of 3.6 ± 1.2 mg/mL and a CC50 of 82.3 ± 2.2 mg/mL, resulting in a selective index of 22.9. Virucidal effects were identified as the underlying mechanism. Furthermore, combining manuka honey with zanamivir or oseltamivir significantly enhanced their efficacy, showcasing the potential medicinal value of honey, particularly manuka honey, against the influenza virus.
The study underscores the potent inhibitory activity of honey, especially manuka honey, against influenza viruses, offering promising medicinal implications. The observed virucidal effects and the synergistic enhancement of known anti-influenza drugs highlight the multifaceted potential of honey in combating influenza infections. Further exploration of the specific mechanisms underlying these effects could contribute to the development of effective anti-influenza therapies.
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