Background: Cough causes concern for parents and is a major cause of outpatient visits. It can impact on quality of life, cause anxiety and affect sleep in parents and children. Several remedies, including honey, have been used to alleviate cough symptoms.
Objectives: To evaluate the effectiveness of honey for acute cough in children in ambulatory settings.
Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, issue 2) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1950 to April Week 2 2009); EMBASE (1990 to April 2009); CINAHL (1982 to April 2009); Web of Science (2000 to April 2009); AMED (1985 to April 2009); and LILACS (1982 to April 2009).
Selection criteria: Randomised controlled trials (RCT) comparing honey given alone or in combination with antibiotics versus nothing, placebo or other over-the-counter (OTC) cough medications to participants aged from two to 18 years for acute cough in ambulatory settings.
Data collection and analysis: Two review authors independently screened search results for eligible studies and extracted data on reported outcomes. Trial authors of the included study were contacted for additional information on unpublished data.
Main results: One RCT of 108 children with upper respiratory tract infections comparing the effect of honey, dextromethorphan and no treatment on cough and sleep quality for coughing children and their parents was included. Comparing symptoms and sleep quality scores of children that received honey with those that received no treatment showed that honey was more effective in reducing frequency of cough (mean difference (MD) -0.99; 95% CI -1.63 to -0.35, bothersome cough (MD -0.93; 95% CI -1.76 to -0.10), and sleep quality of the child (MD -0.92; 95% CI -1.77 to -0.07); but did not differ significantly between the honey versus no treatment groups in resolving severity of cough (MD -0.69; 95% CI -1.46 to 0.07) and sleep quality of the parents (MD 0.80; 95% CI -1.67 to 0.07). Dextromethorphan and honey did not differ significantly on cough frequency (MD -0.49; 95% CI -1.15 to 0.17); cough severity (MD -0.50; 95% CI -1.28 to 0.29), bothersome cough (MD -0.29; 95% CI -1.14 to 0.56) and sleep quality of the children (MD -0.70; 95% CI -1.57 to 0.17) or their parents (MD -0.34; 95% CI -1.24 to 0.55).
Authors' conclusions: We found insufficient evidence to advise for or against the use of honey for acute cough in children.