- Design
- Randomised clinical trial
- Population
- 30 patients after endoscopic sinus surgery for allergic fungal rhinosinusitis
- Primary outcome
- Endoscopic, symptom and radiological scores over 6 months
- Effect
- Better Lund-Kennedy and SNOT-22 with honey; Lund-Mackay similar
A randomised trial of 30 patients after endoscopic sinus surgery for allergic fungal rhinosinusitis compared six weeks of manuka honey sinus irrigation with oral itraconazole, with six months of follow-up. It was published in August 2026.
The honey group had better endoscopic (Lund-Kennedy) scores, lower total IgE and better SNOT-22 symptom scores. Radiological scores and the number of postoperative infections were similar between groups.
Allergic fungal rhinosinusitis is common in India, and itraconazole carries hepatotoxicity and interaction risks. A topical alternative is appealing, but 30 patients is too few to set practice, and the abstract does not give effect sizes.
- Continue steroid irrigation and close endoscopic follow-up after surgery for allergic fungal sinusitis
- Check liver function and interactions when prescribing itraconazole
- Consider honey irrigation only within a protocol or trial until larger studies report
- Use medical-grade honey products rather than food honey for irrigation
Why it matters
Points to a topical option for a condition where systemic antifungals carry real risks.
Don't overread it
Thirty patients and no reported effect sizes; this does not establish superiority over itraconazole.
The statistics, in plain English
With 15 patients per group, chance differences are large, and the abstract reports significance without effect sizes. Similar radiological scores suggest the groups may not differ as much as symptom scores imply.
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