Honey plus coffee versus systemic steroid in the treatment of persistent post-infectious cough: a randomised controlled trial

BACKGROUND: Persistent post-infectious cough (PPC) is a cough that remains after a common cold or an upper respiratory tract infection for more than three weeks or perhaps for many months. Two of the suggested treatments for PPC are systemic steroid and honey plus coffee. AIMS: The aim of this study was to evaluate and compare scientifically the therapeutic effects of these two regimens. METHODS: A double-blind randomised controlled trial was conducted from 2008 to 2011 at the Baqiyatallah University Hospital, Tehran, Iran. Included in the study were 97 adults who had experienced PPC for more than three weeks. Patients with other causes of chronic cough, systemic disease, or abnormal routine laboratory tests were excluded. The participants were distributed into three groups. A jamlike paste was prepared which consisted of honey plus coffee for the first group (‘HC’), prednisolone for the second group (steroid, ‘S’), and guaifenesin for the third group (control, ‘C’). The participants were told to dissolve a specified amount of their product in warm water and to drink the solution every eight hours for one week. All the participants were evaluated before treatment and one week after completion of treatment to measure the severity of their cough. The main outcome measure was the mean cough frequency before and after one week's treatment calculated by a validated visual analogue cough questionnaire score. RESULTS: There were 97 adult patients (55 men) enrolled in this study with a mean age of 40.1 years. The mean (+/− SD) cough scores pre- and post-treatment were: HC group 2.9 (0.3) pre-treatment and 0.2 (0.5) post-treatment (p < 0.001); steroid (‘S’) group 3.0 (0.0) pre-treatment and 2.4 (0.6) post-treatment (p < 0.05); control (‘C’) group 2.8 (0.4) pre-treatment and 2.7 (0.5) post-treatment (p > 0.05). Analysis of variance showed a significant difference between the mean cough frequency before and after treatment in the HC group versus the S group (p< 0.001). Honey plus coffee was found to be the most effective treatment modality for PPC. CONCLUSIONS: A combination of honey and coffee can be used as an alternative medicine in the treatment of PPC.