Take good old honey for common coughs, says official advice
People with acute coughs should take honey and cough medicines before going to the doctor, official advice from the UK says. Coughs caused by cold and flu viruses, as well as viral bronchitis, should last around three weeks, and do not necessarily need a trip to the doctor, according to the advice. The hope is to help stem the misuse of antibiotics, which are no help in treating viruses responsible for most coughs.
The advice comes from the UK's National Institute for Health and Care Excellence (NICE) and Public Health England (PHE). "If the cough is getting worse rather than better or the person feels very unwell or breathless then they would need to contact their GP," a NICE press release states. Cases of suspected pneumonia, or coughs in the particularly young, old or infirm should still seek medical advice.
"Antibiotic resistance is a huge problem and we need to take action now to reduce antibiotic use," PHE's Dr Susan Hopkins says. "Taking antibiotics when you don't need them puts you and your family at risk of developing infections which in turn cannot be easily treated."
The risk stems from so-called superbugs, or bacteria that have developed a resistance to antibiotics. This potentially means diseases which were once treatable with antibiotics no longer are. One response to the problem is to make sure antibiotics are only prescribed when needed.
NICE recommends that health care professionals explain why antibiotics haven't been prescribed when that's the case.
The advice to not use antibiotics is sound, and is in line with older advice given to doctors who should resist prescribing antibiotics when they're not needed. Perhaps more interesting is the claim that honey can help cough symptoms. "Honey and cough medicines containing pelargonium, guaifenesin or dextromethorphan have some evidence of benefit for the relief of cough symptoms," states NICE.
It also notes that honey should only be given to people over 1 year old.
But what is that evidence? The guidelines cite a 2014 study which looked at the benefits of various treatments on the symptoms of acute coughs in children and young people. The effectiveness of honey was compared with other typical treatments: dextromethorphan (a cough suppressant found in many over-the-counter remedies), diphenhydramine (an antihistamine), a placebo, and no treatment at all.
The researchers found that honey was effective at providing symptomatic relief from coughs with only dextromethorphan giving better results. Though just to confuse matters, other studies examining dextromethorphan suggest it's not particularly effective in treating acute coughs (acute being defined as lasting under 21 days).
The guidance also cites a handful of studies which suggest other remedies may help relieve an acute cough, depending on the cause of the cough or symptoms present. In addition to honey, ivy, primrose or thyme may also provide a limited benefit, as may the herbal remedy pelargonium and the expectorant guaifenesin.
The clinical significance of the benefit of honey on cough symptoms is unclear. What is clear is that it certainly doesn't do any harm and is about as effective as many other common non-prescription treatments. Coughs do tend to just get better on their own.
These new guidelines form part of a wider strategy being developed with PHE to promote focus on self-care remedies for patients and far less reliance on antibiotics where they're not really needed – which is really what this advice is about.
Many of us will already have honey to hand in the kitchen cupboard so perhaps it's worth a try should cough symptoms take hold. Interestingly, no guidance is given on how to take it. For what it's worth, I tend to go for one big teaspoonful in hot water with a slice of lemon and fresh ginger rather than simply spooning it straight out of the jar.
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