I came across this
article yesterday at the
American Pharmacists Association's website. One more reason to support your local beekeeper.
I am not sure when this article was published by APhA, but the study they cite in
Archives of Pediatric and Adolescent Medicine was published in 2007.
Honey more effective than honey-flavored dextromethorphan for children's
coughs
Key point: A study published in
Archives of Pediatric
and Adolescent Medicine found that children who received a single dose of
buckwheat honey 30 minutes before bedtime slept better and coughed less than
those who received honey-flavored dextromethorphan or no treatment at all.
Finer points: The primary outcome measure of this partially
double-blinded, randomized study was to compare parental satisfaction with a
single nocturnal dose of buckwheat honey, honey-flavored dextromethorphan, or no
treatment at all in children experiencing nocturnal coughing from an upper
respiratory infection (URI). A total of 105 children aged 2 to 18 years with
URI, nocturnal coughing, and duration of illness 7 days or less were enrolled in
this study, which took place in a single, outpatient, general pediatric
practice.
On the first night of the study, each child received no treatment. The next
morning, parents answered five questions concerning cough frequency and
severity, bothersome nature of cough, quality of child's sleep, and quality of
parent's sleep. Survey responses were stratified using a seven-point Likert
scale. On the second night, each child was randomized to receive a single
syringe containing 2.5 mL, 5 mL, or 10 mL of buckwheat honey or honey-flavored
dextromethorphan, or nothing. The syringes for all of the treatment groups were
opaque and were placed in brown paper bags to ensure investigator blinding. The
honey and dextromethorphan groups were blinded to patients and parents because
the two products had similar consistency, texture, flavor, smell, and sweetness.
Parents answered the same five questions the following morning.
Overall, parents rated honey as significantly better than dextromethorphan or
no treatment for all five criteria (
P < 0.001). Mild adverse events
(e.g., hyperactivity, nervousness, insomnia) were significantly more common in
children treated with honey than those treated with dextromethorphan or nothing
(
P = 0.04).
What you need to know: The recent FDA announcement that the
Consumer Healthcare Products Association is voluntarily modifying the product
labels of all OTC cough and cold medicines to state that the products should not
be used in children under 4 years of age has left pharmacists with virtually no
cough products to recommend for children in this age group. While additional
research is needed to confirm the findings of this study, pharmacists should
consider recommending honey as a symptomatic treatment for cough. Honey is safer
than dextromethorphan in terms of abuse potential and possible serious adverse
events (e.g., dystonia, anaphylaxis, psychosis, death). In addition, no
published findings demonstrating the efficacy of dextromethorphan in children
are available.
What your patients need to know: Tell parents that honey has
been used as an alternative medicine since ancient times. Exactly why or how
honey improves coughing is not known; it may be its viscosity or its antioxidant
properties. Encourage parents to purchase only unfiltered, unheated, unprocessed
honey and to never give honey to children under 1 year of age, because honey can
contain botulism spores in its natural form.
Sources