Thread by @BrighamSK

What is the most effective way to treat nocturnal cough, post-URI cough, or related to post-nasal drip? @thecurbsiders @ShreyaTrivediMD @cjchiu @medrants @InduPartha @aoglasser @ETSshow @meggerber @HannahRAbrams @cacace_frank

Answer will be given in 8-hours in a new tweetorial! Yay!

I didn’t include Benzonatate, Codeine, Steroids (that’s also in the literature from Iran), Albuterol, Nasal Atrovent, or many others, mostly because of poll limitations.

So, @TheCurbsiders, what works well for PITS, URI-associated cough, and nocturnal cough...? Honey. #Tweetorial to follow!!

1/

Most of the data that will be presented is from Pediatrics... of course it would! Who does non-pharmacologic treatment and tetanus best?!

First study (2007) compares Dextromethorphan, Honey, and No Treatment w/Sx improvement best with Honey.
ncbi.nlm.nih.gov/pubmed/18056558

2/

Another (2010) looks at younger children (24-60 mo) and compares Dextromethorphan, Diphenhydramine, and Honey (2.5 mL). Honey was most alleviating, but with all treatment groups (including no treatment) was statistically relevant (clinically?).

ncbi.nlm.nih.gov/pubmed/20618098

3/

Next study (2012) looks at children, again, and compares honey to placebo and found honey to have a "greatest improvement" despite both with statistical improvement.

ncbi.nlm.nih.gov/pubmed/22869830

4/

So what about adults? Study (2013) showed significant improvement when Honey treated with Coffee when compared to steroids and guafenesin. Interesting enough.

ncbi.nlm.nih.gov/pubmed/23966217

5/

But, why, is the question. First, honey helps create a mucosal barrier that helps with limitation stimulation of the afferent branch of the vagus nerve, but more interesting, I think, is that Honey is both bactericidal...

ncbi.nlm.nih.gov/pubmed/22514552

6/

...and bacteriostatic (against MRSA and VRE, no less).

ncbi.nlm.nih.gov/pubmed/22347223

7/

...but there's another action of honey that helps. Similar to how the oral flu vaccine stimulates both IgA and IgG immunity, oral treatment with honey that is harvested locally can stimulate IgA versus IgE immunity similar to oral immunotherapy.

ncbi.nlm.nih.gov/pubmed/12379042

8/

Stimulating IgA (vs IgE) mediated immunity can help with mast-cell de-granulation associated with allergen exposure and, frankly, help dramatically with localized allergic symptoms. Did I convince you or am I just a HUGE QUACK?!

FIN/