Honey vs. pharmacological treatment for acute cough in children: a systematic review and meta-analysis of randomized controlled trials
Abstract
UNLABELLED: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to compare honey with pharmacological treatment in pediatric patients with acute cough. Studies were searched across 5 databases. Analyzed outcomes were cough frequency, severity, and bothersomeness, alongside its impact on the sleep of both children and caregivers. A random-effects meta-analysis was performed using the Review Manager Web tool. A post-hoc subgroup and leave-one-out sensitivity analysis were conducted to evaluate the influence of individual studies and medication class on heterogeneity. 7 studies were included in the systematic review and 6 in the meta-analysis, totaling 576 patients. Among them, 305 (53%) received honey. Participants' mean age ranged from 3 to 5 years, and follow-up duration was limited to 3 days. The primary analysis showed high heterogeneity and no statistically significant differences across most endpoints, except for cough effect on child's sleep, which was significantly reduced in the honey group (MD: -0.73; 95% CI: -1.45 to -0.01; p = 0.05). After sensitivity analysis, honey significantly improved all outcomes, including cough frequency, severity, bothersomeness, sleep quality of children and caregivers, and global score. Subgroup analyses confirmed consistent results regardless of the pharmacological comparator used. Alone, the honey-vs-dextromethorphan group showed significant benefit in two endpoints.
CONCLUSION: While the primary…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 576 participants or records.
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