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The effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis

Abstract:

Background: Antibiotic over-prescription for upper respiratory tract infections (URTIs) in primary care exacerbates anti-microbial resistance. There is a need for effective alternatives to antibiotic prescribing. Honey is a lay remedy for URTIs, and has an emerging evidence base for its use. Honey has anti-microbial properties and guidelines recommended honey for acute cough in children.

Objectives: To evaluate the effectiveness of honey for symptomatic relief in URTIs.

Methods: A systematic review and meta-analysis. We searched Pubmed, Embase, Web of Science, AMED, Cab abstracts, Cochrane Library, LILACS and CINAHL with a combination of keywords and MeSH terms.

Results: We identified 1345 unique records, and 14 studies were included. Overall risk of bias was moderate. Compared to usual care, honey improved combined symptom score (3 studies, mean difference -3.96, 95% CI -5.42 to -2.51, I2 = 0%), cough frequency (8 studies, standardised mean difference (SMD) -0.36, 95% CI -0.50 to -0.21, I2 = 0%), and cough severity, (5 studies, SMD -0.44, 95% CI -0.64 to -0.25, I2 = 20%). We combined two studies comparing honey to placebo for relieving combined symptoms, SMD -0.63 95% CI -1.44 to 0.18, I2 = 90%.

Conclusions: Honey is 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.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1136/bmjebm-2020-111336

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Sub department:
Primary Care Health Sciences
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Sub department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0002-1036-6626
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Sub department:
Primary Care Health Sciences
Role:
Author


Publisher:
BMJ Publishing Group
Journal:
Evidence Based Medicine More from this journal
Volume:
26
Issue:
2
Pages:
57-64
Publication date:
2020-08-18
Acceptance date:
2020-06-21
DOI:
EISSN:
1473-6810
ISSN:
1356-5524


Language:
English
Keywords:
Pubs id:
1114307
Local pid:
pubs:1114307
Deposit date:
2020-06-25
ARK identifier:

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