Al Jaouni, S.K., Al Muhayawi, M.S., Hussein, A., Elfiki, I., Al-Raddadi, R., Al Muhayawi, S.M., . . . Harakeh, S. (2017). Effects of honey on oral mucositis among pediatric cancer patients undergoing chemo/radiotherapy treatment at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia. Evidence-Based Complementary and Alternative Medicine (eCAM), 2017, 5861024. 

To evaluate the effects of honey on severe oral mucositis

Patients were randomized to the honey or control group. The experimental group was given a topical application of honey before the development of mucositis. Both groups received routine oral hygiene with lidocaine, mycostatin, daktarin mouth gel, and mouthwash.

• N = 40   
• MEAN AGE = 8 years (SD = 4.2 years)
• MALES: 52.5%, FEMALES: 47.5%
• CURRENT TREATMENT: Combination radiation and chemotherapy
• KEY DISEASE CHARACTERISTICS: Hematologic tumors were most common.

• SITE: Single site   
• SETTING TYPE: Inpatient    
• LOCATION: Saudi Arabia

• PHASE OF CARE: Active antitumor treatment
• APPLICATIONS: Pediatrics

Open-label, randomized, controlled trial

• World Health Organization (WHO) mucositis grading
• Oral cultures

Analysis showed an absolute risk reduction for the development of grade 3–4 mucositis of 35% among those using honey (p = 0.02). Less Candida colonization (p = 0.003) and bacterial colonization (p = 0.003) were seen in the honey group.

Honey may have some benefit in the management of oral mucositis.

• Small sample (< 100)
• Risk of bias (no blinding)
• Unintended interventions or applicable interventions not described that would influence results
• Frequency of use of honey not clearly described
• Frequency of oral care not clearly described

There may be some benefit from the use of honey to coat oral mucosa in the management of chemotherapy-induced oral mucositis. This study had several limitations.