Cochrane Summaries, March 14, 2012
Cough is a cause for concern for parents and a major cause of outpatient visits in most settings for both children and adults. Cough can impact on quality of life, cause anxiety and affect sleep for parents and children. For this reason an immediate remedy is usually sought by both the caregiver and the recipient. Cochrane reviews have assessed the effectiveness of over-the-counter (OTC) cough medications, but none have studied honey as a cough relief. A systematic review evaluating the effectiveness of honey for reducing acute cough symptoms due to upper respiratory tract infections (URTIs) in children would be useful. A review of two small randomised controlled trials (RCTs) showed that honey was moderately better than 'no treatment' for the relief of cough, reducing bothersome cough, improving quality of sleep for children and parents and reducing the severity of cough.
This review included two small trials involving 265 children, aged two to 18 years. The effects of honey and dextromethorphan on symptomatic relief of cough, bothersome cough, and quality of sleep for both child and parent did not differ. Honey may be better than diphenhydramine for symptomatic relief of cough, reducing the severity of cough, and improving sleep quality for both parent and child. Dextromethorphan and diphenhydramine are both common ingredients in cough medications. Parents of seven children given honey and two given dextromethorphan reported their children suffered mild reactions from insomnia, hyperactivity and nervousness. Parents of three children in the diphenhydramine group reported somnolence. However, as with other medications, its benefit should be considered alongside the adverse effects. The limitation of this review update is that only two small studies with high risk of bias were included.