Manuka honey versus saline sinus irrigation in the treatment of cystic fibrosis-associated chronic rhinosinusitis: A randomized pilot trial.
Clin Otolaryngol. 2020 Aug 27. Epub 2020 Aug 27. PMID: 32852889
Victoria S Lee
OBJECTIVES: Manuka honey attacks biofilms, which contribute to bacterial persistence in cystic fibrosis sinusitis. The primary objective was to determine feasibility of investigating manuka honey as an irrigation treatment for cystic fibrosis sinusitis and secondarily to assess the treatment's preliminary effectiveness.
DESIGN: Prospective, single-blinded (clinician only), randomized, parallel two-armpilot trial.
SETTING: Tertiary rhinology clinic.
PARTICIPANTS: Subjects had recalcitrantcystic fibrosis sinusitis and previous sinus surgery. They received manuka honey or saline sinus irrigations twice daily for 30 days.
MAIN OUTCOME MEASURES: Main outcomes were recruitment/retention rates andtolerability. Preliminary effectivenesswas assessed based onquality of life Sino-Nasal Outcome Test-22and Lund-Kennedy endoscopic change scores and post-treatment culture negativity.
RESULTS: Over 10 months, 13 subjects were enrolled, and 77% (10/13) were included in the analysis. Manuka honey irrigations were well-tolerated.The quality of lifechange score was clinically significant for manuka honey (-9 [-14,-6]) but not saline (-5 [-9,-1]), although the differencewas not statistically significant (p=0.29). Lund-Kennedy endoscopic change score was significantly better for manuka honey (-3 [-5,-3]) versussaline (0 [0,0]) (p=0.006). There was no difference in post-treatment culture negativity between manuka honey (1/5, 20%) and saline (0/5, 0%) (p=1.00).
CONCLUSIONS: Manuka honey irrigations were well tolerated, and retention rates were high.Preliminary data showed thatmanuka honey achieved a clinically important difference in quality of life score anda significantly better endoscopic outcome. Microbiological controlwas difficult to achieve. A future definitive trial would require multi-institutional recruitment.