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Herbal Medicine in Children With Respiratory Tract Infection: Systematic Review and Meta-Analysis.

  • 2018-01
  • Academic pediatrics 18(1)
    • Dennis Anheyer
    • Holger Cramer
    • Romy Lauche
    • Felix Joyonto Saha
    • Gustav Dobos

Study Design

Type
Meta-Analysis
Sample size
n = 2,181
Population
children and adolescents (age 0 to 18 years) with RTI
Methods
Systematic review of randomized controlled trials comparing herbal therapy with no treatment, placebo, or any pharmaceutical medication; searches in Medline/PubMed, Scopus, and the Cochrane Library through February 12, 2015

Background

Herbal medicines are particularly regarded as an alternative or complement to conventional pharmaceuticals in the treatment and prevention of respiratory tract infections (RTIs). Therefore, the purpose of this review was to identify evidence for herbal therapy in the treatment of RTIs concerning effectiveness and safety.

Methods

Medline/PubMed, Scopus, and the Cochrane Library were searched through February 12, 2015. Randomized controlled trials that compared herbal therapy with no treatment, placebo, or any pharmaceutical medication in children and adolescents (age 0 to 18 years) with RTI were eligible.

Results

Eleven trials with 2181 participants were included. No clear evidence for Echinacea (4 trials) or an herbal compound preparation (1 trial) in preventing RTI symptoms was found. Meta-analysis revealed evidence for efficacy (responder rates: risk ratio [RR], 2.56; 95% confidence interval [CI], 1.54-4.26; P < .01; heterogeneity: I2 = 38%; chi-square = 9.63; P = .14) and safety (patients with adverse events: RR, 1.06; 95% CI, 0.42-2.66; P = .9; heterogeneity: I2 = 72%; chi-square = 10.64; P = .01) of Pelargonium sidoides in treating RTI symptoms compared with placebo (6 trials).

Conclusions

Because of conflicting evidence in the included studies no concrete conclusion on effects of Echinacea could be drawn so far. In the case of Pelargonium sidoides, meta-analysis revealed moderate evidence for efficacy and safety in the treatment of RTIs in children.

Research Insights

  • Echinacea→Prevented Respiratory Tract Infection Symptom

    No clear evidence for Echinacea (4 trials) or an herbal compound preparation (1 trial) in preventing RTI symptoms was found.

    Effect
    Neutral
    Effect size
    Small
  • Geranium→Reduced Respiratory Tract Infection Symptom

    Meta-analysis revealed evidence for efficacy (responder rates: risk ratio [RR], 2.56; 95% confidence interval [CI], 1.54-4.26; P < .01; heterogeneity: I2 = 38%; chi-square = 9.63; P = .14) ... of Pelargonium sidoides in treating RTI symptoms compared with placebo (6 trials).

    Effect
    Beneficial
    Effect size
    Large

Adverse Events Reported

  • Geranium→Overall tolerability

    safety (patients with adverse events: RR, 1.06; 95% CI, 0.42-2.66; P = .9; heterogeneity: I2 = 72%; chi-square = 10.64; P = .01) of Pelargonium sidoides in treating RTI symptoms compared with placebo (6 trials).

    Finding
    No significant difference
    Magnitude
    RR, 1.06; 95% CI, 0.42-2.66; P = .9
    Significant
    No
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