BMJ -EVIDENCE BASED MEDICINE -18TH AUGUST 2020

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 antimicrobial 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 antimicrobial 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 with usual care, honey improved combined symptom score , cough frequency, and cough severity .

Conclusions
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.