Blog entry written on: Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis (bmjebm-2020-111336)

Author: Hibatullah Abuelgasim

Honey is a folklore favourite when it comes to cough and cold remedies. Everyone who has ever had a cold knows how annoying the symptoms can be. Unfortunately, there’s not much a doctor can give you for them. Evidence shows that over-the-counter medications and antibiotics are not effective for symptoms of coughs and colds (known as ‘upper respiratory tract infections’). A quick Google search, however, turns up numerous articles recommending honey as a natural symptom-reliever.

But is this fact, or fiction? Is there any evidence that honey actually does improve cough and cold symptoms?

We designed our study, “The effectiveness of honey for symptomatic relief in upper respiratory tract infections: A systematic review and meta-analysis”, to answer this question. We analysed studies comparing honey to placebo, and to ‘usual care’, which included a number of over-the-counter medications. We found that for combined symptoms, cough frequency and cough severity, honey is actually better than usual care.

A previous study had evaluated the use of honey for acute cough in children, concluding that honey is likely better than some other treatments or placebo. To differentiate our review, we looked at studies including:

• both adults and children
• any symptoms of upper respiratory tract infections (although the majority did focus on cough)
• honey administered in any way (e.g. neat, dissolved in water, mixed with milk)

The result was a wider-scoping review, but the trade-off was that some studies we included differed greatly, which meant that our conclusions could not be as strong. We also could not recommend a particular ‘dose’ or ‘route’ for taking honey, as we included so many different formulations.

Our findings are exciting, for a few reasons. Upper respiratory tract infections, like coughs and colds, are the biggest cause of antibiotic prescribing in general practice, partly because GPs like to be able to offer something to their patients – which makes sense! But, as the majority of upper respiratory tract infections are caused by viruses, antibiotic prescribing is not effective. What’s more, antibiotic overprescribing drives antimicrobial resistance, which may become a significant barrier to treating infections in the future.

The results of our study enable doctors to be able to offer a patient something for their cough and cold symptoms, without increasing the use of unnecessary antibiotics. Although we did not look specifically at adverse effects, as honey is a foodstuff, it’s safe. The exception is in children under the age of 1 year, as there is a risk of botulism. Honey is also fairly cheap and widely available.

So, the next time you have a cold, some honey might help you get your buzz back!

Author: Hibatullah Abuelgasim

Short bio: Hibatullah is a medical student at the University of Oxford Medical School.

COI: Co-author of “The effectiveness of honey for symptomatic relief in upper respiratory tract infections: A systematic review and meta-analysis”, along with Charlotte Albury and Joseph Lee. Joseph Lee is a hobby beekeeper. No other conflicts of interest.

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