Antibiotics are most frequently prescribed for the treatment of upper respiratory tract infections. Because the majority of these infections are viral, however, the prescription of antibiotics is often ineffective and contributes to antimicrobial resistance. Honey, by contrast, is an inexpensive, widely used traditional treatment for upper respiratory tract infections and is recommended for acute cough in children. Researchers systematically reviewed the literature regarding the use of honey for the amelioration of upper respiratory tract infection symptoms in people of all ages.

Fourteen randomized controlled trials were included in the analysis. All compared honey-any type, administered in any way, either alone or in conjunction with other treatments-with at least one other option (no treatment, placebo, or usual care) for the treatment of upper respiratory tract infection symptoms. "Usual care" referred to common over-the-counter drugs.

Compared with usual care, honey was associated with a significantly greater improvement in combined symptoms, cough frequency, and cough severity. Comparison with placebo was limited because of a lack of evidence. Adverse effects, which were not observed in most patients who received honey, were relatively mild and included nausea.

One of the limitations of this review and meta-analysis was the risk of bias in the included studies. This risk varied, and the authors state that they didn't assess study quality in other ways. In addition, the usual care interventions were highly varied, and there were insufficient data for the researchers to compare different types or doses of honey.

The authors recommend that clinicians consider honey as an alternative to antibiotics when prescribing treatment for upper respiratory tract infections.