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Manuka honey sinus irrigation for the treatment of chronic rhinosinusitis: a randomized controlled trial.

  • 2016-12-09
  • International forum of allergy & rhinology 7(4)
    • Victoria S Lee
    • Ian M Humphreys
    • Patricia L Purcell
    • Greg E Davis

Study Design

Type
Randomized Controlled Trial (RCT)
Sample size
n = 22
Population
patients with active chronic rhinosinusitis (CRS) and prior sinus surgery
Methods
prospective single-blinded (clinician only) randomized controlled trial, patients received either MH or saline (SAL) sinus irrigations twice daily for 30 days and were offered oral antibiotics and/or oral/topical steroids as indicated
Blinding
Single-blind
Duration
30 days
Funding
Unclear

Background

Manuka honey (MH) has been shown in vitro to be effective against biofilm-producing bacteria. This study assessed the effectiveness of MH for patients with active chronic rhinosinusitis (CRS) and prior sinus surgery.

Methods

This prospective single-blinded (clinician only) randomized controlled trial recruited patients with active CRS and prior sinus surgery. Patients received either MH or saline (SAL) sinus irrigations twice daily for 30 days and were offered oral antibiotics and/or oral/topical steroids as indicated. Outcomes were 22-item Sino-Nasal Outcome Test (SNOT-22) change score (primary), culture negativity, and Lund-Kennedy endoscopic change score.

Results

Forty-two patients were analyzed (MH, n = 20; SAL, n = 22). The SNOT-22 change score achieved a clinically significant improvement in both groups but was similar between MH (median [-20, -1]) and SAL (-12.5 [-22, -6]) (p = 0.57). Culture negativity was better on MH (8/19, 42%) compared to SAL (4/21, 19%), nearing statistical significance (p = 0.11). Lund-Kennedy endoscopic change score improved in both groups but was not statistically better on MH (-3 [-5, 0]) compared to SAL (-1 [-2, 0]) (p = 0.20). For patients not receiving oral antibiotics/steroids, culture negativity was statistically better on MH (5/10, 50%) compared to SAL (0/6, 0%) (p = 0.04). MH was well-tolerated. No adverse events were reported.

Conclusion

In patients with active CRS and prior sinus surgery, both MH and SAL improved outcomes, but there was no statistically significant difference between these groups. However, in the subset that did not receive oral antibiotics/steroids, culture negativity was statistically better on MH, suggesting that MH alone may be effective for acute exacerbations of CRS.

Research Insights

  • Manuka Honey→Improved Culture Negativity

    Culture negativity was better on MH (8/19, 42%) compared to SAL (4/21, 19%), nearing statistical significance (p = 0.11).

    Effect
    Neutral
    Effect size
    Small
  • Manuka Honey→Improved Lund-Kennedy Endoscopic Score

    Lund-Kennedy endoscopic change score improved in both groups but was not statistically better on MH (-3 [-5, 0]) compared to SAL (-1 [-2, 0]) (p = 0.20).

    Effect
    Neutral
    Effect size
    Small
  • Manuka Honey→Improved Sino-Nasal Outcome Test Score

    The SNOT-22 change score achieved a clinically significant improvement in both groups but was similar between MH (median [interquartile range]: -12 [-20, -1]) and SAL (-12.5 [-22, -6]) (p = 0.57).

    Effect
    Neutral
    Effect size
    Small

Adverse Events Reported

  • Manuka Honey→Overall tolerability

    MH was well-tolerated. No adverse events were reported.

    Finding
    Reported
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