Honey for coughs could fight antibiotic over-prescription, flags study

20 Aug 2020 --- Researchers are recommending honey as an alternative to antibiotics in certain cases of upper respiratory tract infections (URTIs). The low cost and easy accessibility of honey may likely contribute to this treatment’s increased acceptability by patients, clinicians and policymakers. Notably, it could help fight against antibiotic over-prescription, as well as bypassing undesirable side effects when unnecessary.

“There has been a common consumer understanding that honey is helpful and there is scientific evidence that its use is effective in children over the age of one for coughs. Our research shows that honey is effective for relieving symptoms of URTIs, especially cough,” lead author Hibatullah Abuelgasim, a fifth-year medical student at the University of Oxford, UK, tells NutritionInsight. 

However, until now, there has been no study to the researchers’ knowledge that has reviewed the available evidence to see if honey is indeed effective in adults and children over the age of one. Importantly, Abuelgasim highlights that his research team’s findings did not provide any evidence regarding COVID-19 and honey specifically, as all of the studies included in the review pre-dated the pandemic.

The study found honey to be a “reasonable alternative” to antibiotics to treat URTIs.Compared with usual care – defined in the study as “any commonly used treatments” against URTIs – honey improved the symptom score in three studies, cough frequency in eight studies and cough severity in five studies. The researchers of the BMJ-published review also combined two studies comparing honey with placebo for relieving combined symptoms.

Recommending honey over antibiotics?
When clinicians prescribe for URTIs, the researchers state they would “recommend honey as an alternative to antibiotics.” According to the team’s findings, antibiotics are associated with significant adverse effects in children and adults. “Given that a lack of alternative therapies and a desire to preserve the patient-doctor relationship are two key contributors to antibiotic over-prescription by general practitioners, our finding that honey may be effective is important in the clinical context: honey is a reasonable alternative.”

The researchers did not observe any adverse effects in most patients given honey. “Relatively mild” effects noted were nausea. “Data on the use of honey and other complementary and alternative medicines in the UK and doctors’ and patients’ perceptions of these therapies are limited. Because of the limitations to the evidence, particularly for adults, we would support large, high-quality placebo-controlled trials,” the study reads.

When asked if he would recommend honey over antibiotics in the majority of cases, Abuelgasim responds: “No. If antibiotics are prescribed by doctors, they are prescribed with a clear indication. Our study suggests honey could be an alternative if antibiotics are not indicated. This is usually the case in mild URTIs – coughs and colds – when you are otherwise well. If you are at all worried about your symptoms, or you would normally go to the doctor with your symptoms, you should absolutely still do that,” he concludes.

A variety of other natural ingredients have also surfaced in the fight against respiratory difficulties, including fucoidan, pomegranate, probiotics, and ashwagandha and propolis, a resinous honey product. 

“Some natural remedies for colds and coughs should not be dismissed, and are worth scientific testing. However, we would emphasize that some natural remedies have potential for harm, so you should talk to a pharmacist if you are considering trying something new; they can offer good advice on safety,” Abuelgasim underlines.

By Anni Schleicher