BMJ Open (May 2019)

Kanuka honey versus aciclovir for the topical treatment of herpes simplex labialis: a randomised controlled trial

  • Nick Shortt,
  • Alex Semprini,
  • Mark Weatherall,
  • Richard Beasley,
  • Irene Braithwaite,
  • Angela Liu,
  • Melanie McConnell,
  • Joseph Singer,
  • Darmiga Thayabaran,
  • Abbie Copinga,
  • Abigail Cadwallader,
  • Ahmad Zareh,
  • Aidan Kortegast,
  • Al-Sheibani Saif,
  • Alaina van Zyl,
  • Alex Graham,
  • Alice Liu,
  • Alice Manch,
  • Alison van Wyke,
  • Amanda Barkley,
  • Amy Zhuang,
  • Andrew Mcglashen,
  • Androulla Kotrotsos,
  • Angela Blackwood,
  • Angeline Day-Mesuré,
  • Annabel Turley,
  • Anne Lim,
  • Anne Marie-Nimmo,
  • Anstey Harsant,
  • Anthony Roberts,
  • Ashley Cronin,
  • Barbara Mcrae,
  • Blair Finlayson,
  • Bob Kim,
  • Brandon,
  • Brendon Mcintosh,
  • Brian Johnston,
  • Carina Soeteman,
  • Carla Mcinness,
  • Carrol Newman,
  • Cassie Butler,
  • Catherine Hosler,
  • Cathy Hight,
  • Chantel Kissick,
  • Charlotte Schimanski,
  • Chau Ly,
  • Cheryl Mabbett,
  • Chris Wrapson,
  • Christy Biju,
  • Chuck Varghese,
  • Claire Livingston,
  • Corry Bezems,
  • Danielle Stewart,
  • Daryl Sayer,
  • David Postlewaight,
  • Deb Lawrence,
  • Debora Ngny,
  • Deborah Ellison,
  • Debra Clutterback,
  • Delphine Destrez,
  • Diana Montelli,
  • Dipika Parmar,
  • Dixie Howard,
  • Donnie Loh,
  • Eddie See,
  • Elda Lubbe,
  • Eric Li,
  • Evan Tan,
  • Fiona Mclachlan,
  • Fiona Srush,
  • Fran Chen,
  • Garth Mitchinson,
  • Gina Azer-Iskander,
  • Glenn Summerville,
  • Grace O’conner,
  • Grant Bell,
  • Hayley Garvin,
  • Helen Jarvie,
  • Henriette Meyer,
  • Ingrid Nickson,
  • Ingrid Reed,
  • Irene Nicks,
  • Jackie Jamieson,
  • Jacqui Brus,
  • Jacqui Craw,
  • James Westbury,
  • Jan Green,
  • Janet Downing,
  • Jayne Lewis,
  • Jenna Ludlow,
  • Jenni Puckley,
  • Jennifer Gerbes,
  • Jenny Sparks,
  • Jenny Wu,
  • Jess Barton,
  • Jessica Ensor,
  • Jilly Alexander,
  • Jim Sherborne,
  • Joanna Topliss,
  • Jordan Jeffray,
  • Jordon Hinton,
  • Joseph Tsou,
  • Joy Birch,
  • Julia Mcdonald,
  • Julie Earwaker,
  • Julie Lamb,
  • Julie Summers,
  • Kadyn Lowe,
  • Kaleigh Mackel,
  • Karen Rich,
  • Karen Chen,
  • Karen Wainman,
  • Karena Hall,
  • Kate Adams,
  • Kate Griffin,
  • Kayleigh Mackel,
  • Kelly Burgess,
  • Kelly Harvey,
  • Kelly Shearer,
  • Kelsi Burns,
  • Kerry Dean,
  • Kerry Oxenham,
  • Kritika Singh,
  • Lara Blaikie,
  • Leanne Hall,
  • Leanne Herbert,
  • Leanne Hosking,
  • Leanne Steele,
  • Leigh Vaughan,
  • Lesley Robertson,
  • Levi Bian,
  • Linda Herman,
  • Linda Joe,
  • Linda Southby,
  • Lisa Josephs,
  • Lisa Mitchell,
  • Lorina Lu,
  • Lorraine Brunton,
  • Lucy Armstrong,
  • Lynda Bell,
  • Malinda Ouk,
  • Malli Kotali,
  • Marcus Liddle,
  • Margaret Helms,
  • Marion Gray,
  • Mark Arundel,
  • Mark Webster,
  • Martin Boyle,
  • Maryanne Smyth,
  • Mate Hegedus-Gaspar,
  • Matthew Grey,
  • Maureen Raju,
  • Melanie Wong,
  • Michelle Hwang,
  • Michelle Nawisielski,
  • Michelle Speirs,
  • Natascha Roughton,
  • Navjot Kaw,
  • Neha Chand,
  • Nehad Kamel,
  • Neville Puckey,
  • Nicholas Tee,
  • Nimmi Gnanasekaran,
  • Nolan Mcrae,
  • Noor Al-Rawe,
  • Oliver Rew,
  • Olivia Haslam,
  • Outi Kolju,
  • Palak Mehta,
  • Patrick Lim,
  • Peter Neal,
  • Rachael Gerretzen,
  • Rachael Munns,
  • Rachel Yang,
  • Rachelle Smith,
  • Raksha Goundar,
  • Rav Singh,
  • Ravniel Singh,
  • Rebecca Coley,
  • Rebecca Hesom,
  • Rebekah Beard,
  • Reece Olsen,
  • Renee Belling,
  • Robyn Morrison,
  • Roseanna Mcdonald,
  • Ruby Willing,
  • Saif Al-Sherbeni,
  • Sally Purdie,
  • Sam Betty,
  • Sam Appleford,
  • Samantha Fordham,
  • Samit Patel,
  • Sara Preston,
  • Sarah Wallace,
  • Sascha Ion,
  • Shahlaa Al Salih,
  • Sharon Sullivan,
  • Shazeel Rauf,
  • Sheryl Montgomerie,
  • Shilpa Narain,
  • Shirin Namjou,
  • Shuji Zhang,
  • Simerjeet Singh,
  • Sjaani Stanley,
  • Sonia Schwaum,
  • Steve Jo,
  • Sultana Zannat,
  • Tanya Baker,
  • Tyler Pornchaisuksiri,
  • Utsav Sharma,
  • Vicki Douglas,
  • Victoria Rameke,
  • Vincent Ho,
  • Vioky Usher,
  • Violet Harley,
  • Vishwatej Gangapuri,
  • Warren Greene,
  • Wendy Parkes,
  • William Gia,
  • Wilma Gordon,
  • Yalun Weng,
  • Yasmin Razoki,
  • Yolanda Savage,
  • Zheng Li

DOI
https://doi.org/10.1136/bmjopen-2018-026201
Journal volume & issue
Vol. 9, no. 5

Abstract

Read online

Objective To compare New Zealand medical grade kanuka honey with topical aciclovir for the treatment of herpes simplex labialis.Design Prospective parallel randomised controlled open-label superiority trial.Setting 76 community pharmacies across New Zealand between 10 September 2015 and 13 December 2017.Participants 952 adults randomised within the first 72 hours of a herpes simplex labialis episode.Interventions Random assignment 1:1 to either 5% aciclovir cream or medical grade kanuka honey (90%)/glycerine (10%) cream, both applied five times daily.Outcome measures The primary outcome was time from randomisation to return to normal skin (stage 7). Secondary outcomes included time from randomisation to stage 4 (open wound), time from stage 4 to 7, maximal pain, time to pain resolution and treatment acceptability.Results Primary outcome variable: Kaplan-Meier-based estimates (95% CI) for the median time in days for return to normal skin were 8 (8 to 9) days for aciclovir and 9 (8 to 9) for honey; HR (95% CI) 1.06 (0.92 to 1.22), p=0.56. There were no statistically significant differences between treatments for all secondary outcome variables. No related serious adverse events were reported.Conclusion There was no evidence of a difference in efficacy between topical medical grade kanuka honey and 5% aciclovir in the pharmacy-based treatment of herpes simplex labialis.Trial registration number ACTRN12615000648527;Post-results