Persistent post-infectious cough (PPC) is a common yet frustrating aftermath of upper respiratory tract infections, affecting millions worldwide. While steroids like prednisolone are often prescribed, a groundbreaking 2013 study revealed that a simple, natural mixture of honey and coffee could provide superior relief. This report delves into the details of that research, its methodology, findings, and implications, while exploring whether recent studies have built upon or challenged these results. Drawing from scientific literature up to 2026, we examine the potential of this home remedy as an alternative to pharmaceutical interventions, highlighting its efficacy, safety, and accessibility.

Background on Persistent Post-Infectious Cough

Upper respiratory tract infections (URTIs), such as the common cold, flu, or other viral illnesses, are among the most prevalent health issues globally. While most symptoms resolve within a week or two, a lingering cough—known as persistent post-infectious cough (PPC)—can persist for three weeks or longer in 11-25% of cases. PPC is characterized by a tickling or irritating sensation in the throat, leading to frequent coughing fits that disrupt daily life, sleep, and work. It’s often triggered by hypersensitivity in the airways following viral damage to the respiratory mucosa.Traditional treatments for PPC include over-the-counter cough suppressants, antihistamines, bronchodilators, and systemic corticosteroids like prednisolone, which aim to reduce inflammation. However, these options can have side effects, such as drowsiness, gastrointestinal issues, or long-term risks with steroids like bone density loss. Natural remedies, including honey, have long been used anecdotally for cough relief due to its soothing, antimicrobial, and anti-inflammatory properties. Coffee, with its caffeine content, acts as a mild bronchodilator and may help loosen mucus. The combination of the two was hypothesized to offer synergistic benefits, prompting scientific investigation.

The Landmark 2013 Study: Methodology and Design

In a double-blind, randomized controlled trial published in the Primary Care Respiratory Journal, researchers from Baqiyatallah University of Medical Sciences in Tehran, Iran, led by Mohammad Ali Raeessi, compared the efficacy of honey plus coffee against systemic steroids and a placebo for treating PPC. The study, conducted between 2008 and 2011, involved 97 adult participants (55 men, mean age 40.1 years) who had experienced a cough lasting more than three weeks after a URTI. Exclusion criteria included smokers, those with known allergies, or patients with underlying conditions like asthma or gastroesophageal reflux disease that could confound results.Participants were randomly assigned to three groups:

• Honey plus Coffee (HC) Group: Received a jam-like paste containing natural honey and instant coffee. Dosage: 25 grams dissolved in 200 mL of warm water, taken every eight hours for one week.
• Steroid (S) Group: Received prednisolone in a similar paste form, at a dose equivalent to 75 mg per day.
• Control (C) Group: Received a placebo paste.

Cough severity was assessed using a validated seven-point questionnaire, scoring frequency from 0 (no cough) to 3 (severe, frequent coughing). Evaluations occurred before treatment and two weeks after, with participants monitored for one month post-treatment. The trial was double-blinded to minimize bias, and statistical analysis used ANOVA to compare changes in cough scores.

Key Results and Findings

The results were striking and statistically significant:

• The HC group saw their mean cough frequency score plummet from 2.9 (±0.3) pre-treatment to 0.2 (±0.5) post-treatment (p < 0.001), representing approximately a 93% reduction.
• The S group improved modestly from 3.0 (±0.0) to 2.4 (±0.6) (p < 0.05), about a 20% reduction.
• The C group showed negligible change, from 2.8 (±0.4) to 2.7 (±0.5) (p > 0.05).

Overall, the honey-coffee mixture outperformed steroids significantly (p < 0.001), with most participants in the HC group reporting complete resolution of symptoms within the week. No serious adverse effects were noted in any group, though steroids can carry risks with prolonged use.A follow-up 2014 meta-analysis by the same research team, incorporating data from three trials (totaling 245 participants), compared five regimens: prednisolone, honey alone, coffee alone, honey plus coffee, and placebo. It reaffirmed that honey plus coffee was the most effective, with rapid symptom relief and no significant side effects. The meta-analysis suggested that the combination leverages honey’s mucolytic and anti-inflammatory effects with coffee’s bronchodilatory properties.

Treatment Group	Pre-Treatment Cough Score (Mean ± SD)	Post-Treatment Cough Score (Mean ± SD)	Change	p-Value
Honey + Coffee	2.9 ± 0.3	0.2 ± 0.5	-2.7	<0.001
Steroid (Prednisolone)	3.0 ± 0.0	2.4 ± 0.6	-0.6	<0.05
Control	2.8 ± 0.4	2.7 ± 0.5	-0.1	>0.05

Implications for Treatment and Health Practice

This research positions honey and coffee as a promising, low-cost alternative to steroids for PPC, especially in resource-limited settings or for patients preferring natural options. The mixture is easy to prepare—typically 1-2 teaspoons each of honey and instant coffee in warm water—and generally safe for adults, though diabetics should monitor sugar intake from honey, and those sensitive to caffeine may experience mild jitters.Broader implications include reducing reliance on steroids, which can suppress the immune system and lead to dependency. Guidelines from bodies like the World Health Organization already endorse honey for cough relief in children (over age 1), and this study extends potential benefits to adults. However, PPC should not be self-diagnosed; persistent coughs warrant medical evaluation to rule out serious conditions like pneumonia or cancer.

Recent Developments and Limitations

Despite the 2013 study’s impact (cited over 61 times), no large-scale replications or new randomized trials specifically comparing honey-coffee to steroids have emerged between 2020 and 2026. A 2021 systematic review from the University of Oxford found honey superior to usual care for acute URTIs, reducing cough frequency by about 36% more than placebo. Similarly, a 2025 systematic review concluded that honey improves respiratory infection symptoms and could supplement conventional treatments. Social media and wellness sites continue to popularize the honey-coffee remedy, often referencing the original study, but without new clinical data.Limitations of the 2013 trial include its small sample size, single-center design, and focus solely on PPC rather than broader upper respiratory symptoms. The short follow-up period also leaves questions about long-term efficacy. Future research should involve larger, multicenter trials and explore mechanisms, such as how caffeine enhances honey’s effects.

The evidence from the 2013 trial and supporting meta-analysis suggests that a humble cup of honey-sweetened coffee could eclipse steroids in treating persistent coughs post-infection, offering faster, safer relief with everyday ingredients. While not a cure-all, this natural duo represents an empowering option in an era of rising interest in holistic health. For anyone battling a stubborn cough, consulting a healthcare provider remains key, but adding honey and coffee to the mix might just sweeten the path to recovery.

Citations

1. Raeessi MA, et al. Honey plus coffee versus systemic steroid in the treatment of persistent post-infectious cough: a randomised controlled trial. PubMed. https://pubmed.ncbi.nlm.nih.gov/23966217
2. Raeessi MA, et al. Honey plus coffee versus systemic steroid in the treatment of persistent post-infectious cough: a randomised controlled trial. Semantic Scholar. https://www.semanticscholar.org/paper/Honey-plus-coffee-versus-systemic-steroid-in-the-of-Raeessi-Aslani/164252e0d245452ce75db3695c84155be7c03331
3. Raeessi MA, et al. “Persistent post-infectious cough” is better treated by which one? Prednisolone, Honey, Coffee, or Honey plus coffee: A meta-analysis. NOPR. https://nopr.niscpr.res.in/bitstream/123456789/29112/1/IJTK%2013(3)%20453-460.pdf
4. Honey and Coffee Better than Steroids for Persistent Cough? Regenerative MC. https://regenerativemc.com/honey-and-coffee-better-than-steroids-for-cough
5. Chaplin S. Is honey effective for upper respiratory tract infection? Prescriber. https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/psb.1927
6. The Therapeutic Effect of Honey on Respiratory Infections: A Systematic Review. ResearchGate. https://www.researchgate.net/publication/389405564_The_Therapeutic_Effect_of_Honey_on_Respiratory_Infections_A_Systematic_Review