Honey for acute cough in children

  • von

Olabisi Oduwole, Ekong E Udoh, Angela Oyo‐Ita, Martin M Meremikwu

Cochrane Review: Version published: 10 April 2018 in Cochrane Library

Zusammenfassung:

Insgesamt gibt es keine eindeutige Evidenz für oder gegen Honig. Doch Honig kann Kindern mit akutem Husten offenbar ein wenig helfen, indem Beschwerden gelindert und die Dauer gering verkürzt wird. Er wirkt wahrscheinlich etwas besser als Placebo, abwartendes Nichtstun oder Diphenhydramin. Es ergab sich kaum ein Unterschied im Vergleich zu Dextromethorphan.

This is an update of reviews previously published in 2014, 2012, and 2010.

Randomised controlled trials comparing honey alone versus no treatment, placebo, honey‐based cough syrup, or other over‐the‐counter cough medications for children aged 12 months to 18 years for acute cough in ambulatory settings.

Main results

We included six randomised controlled trials involving 899 children; we added three studies (331 children) in this update.

Studies compared honey with dextromethorphan, diphenhydramine, salbutamol, bromelin (an enzyme from the Bromeliaceae (pineapple) family), no treatment, and placebo. Five studies used 7‐point Likert scales to measure symptomatic relief of cough; one used an unclear 5‐point scale. In all studies, low score indicated better cough symptom relief.

Using a 7‐point Likert scale, honey probably reduces cough frequency better than no treatment or placebo (no treatment: mean difference (MD) ‐1.05, 95% confidence interval (CI) ‐1.48 to ‐0.62; I² = 0%; 2 studies; 154 children; moderate‐certainty evidence; placebo: MD ‐1.62, 95% CI ‐3.02 to ‐0.22; I² = 0%; 2 studies; 402 children; moderate‐certainty evidence). Honey may have a similar effect as dextromethorphan in reducing cough frequency (MD ‐0.07, 95% CI ‐1.07 to 0.94; I² = 87%; 2 studies; 149 children; low‐certainty evidence). Honey may be better than diphenhydramine in reducing cough frequency (MD ‐0.57, 95% CI ‐0.90 to ‐0.24; 1 study; 80 children; low‐certainty evidence).

Giving honey for up to three days is probably more effective in relieving cough symptoms compared with placebo or salbutamol. Beyond three days honey probably had no advantage over salbutamol or placebo in reducing cough severity, bothersome cough, and impact of cough on sleep for parents and children (moderate‐certainty evidence). With a 5‐point cough scale, there was probably little or no difference between the effects of honey and bromelin mixed with honey in reducing cough frequency and severity.

Adverse events included nervousness, insomnia, and hyperactivity, experienced by seven children (9.3%) treated with honey and two children (2.7%) treated with dextromethorphan (risk ratio (RR) 2.94, 95% Cl 0.74 to 11.71; I² = 0%; 2 studies; 149 children; low‐certainty evidence). Three children (7.5%) in the diphenhydramine group experienced somnolence (RR 0.14, 95% Cl 0.01 to 2.68; 1 study; 80 children; low‐certainty evidence). When honey was compared with placebo, 34 children (12%) in the honey group and 13 (11%) in the placebo group complained of gastrointestinal symptoms (RR 1.91, 95% CI 1.12 to 3.24; I² = 0%; 2 studies; 402 children; moderate‐certainty evidence). Four children who received salbutamol had rashes compared to one child in the honey group (RR 0.19, 95% CI 0.02 to 1.63; 1 study; 100 children; moderate‐certainty evidence). No adverse events were reported in the no‐treatment group

Authors‘ conclusions

Honey probably relieves cough symptoms to a greater extent than no treatment, diphenhydramine, and placebo, but may make little or no difference compared to dextromethorphan. Honey probably reduces cough duration better than placebo and salbutamol. There was no strong evidence for or against using honey. Most of the children received treatment for one night, which is a limitation to the results of this review. There was no difference in occurrence of adverse events between the honey and control arms.

Fazit:

Honig ist eine gute Möglichkeit der Therapie des kindlichen Hustens. Besser als Chemie allemal. Wegen neutroxinbildenden Sporen erst ab 12 Monaten.

Fazit Regen:

Insgesamt gibt es kaum gute Evidenz für chemische und nicht-chemische Maßnahmen. Honig scheint beim harmlosen Husten eine harmlose Option zu sein.