Echinacea purpurea is a plant species that is often used as a dietary supplement or herbal remedy to support the immune system – especially for colds and respiratory infections. This scientific paper summarizes in a systematic review with meta-analysis the results from several controlled trials in children that investigated whether echinacea can help with upper respiratory tract infection (URTI)and otitis media.
A total of 9 well-controlled studies with just over 3,000 participants were evaluated. The results indicate that echinacea is effective in children:
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can reduce the frequency of respiratory tract infections – infections occurred less frequently than without echinacea.
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can shorten the duration of symptoms, which can be particularly important for parents.
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reduced the need for antibiotics because fewer complications occurred.
Echinacea also showed a reduced number of episodes of otitis media, although the effect was less clear in terms of the duration of the symptoms. Overall, adverse effects were mostly mild, but slightly more frequent than in the placebo group.
Conclusion: Echinacea purpurea can help reduce the incidence and severity of respiratory infections in children and reduce the need for antibiotics – it is well tolerated overall, although further research is needed on its optimal use
Background
Respiratory tract infections are among the most common complaints in children worldwide and can lead to complications such as middle ear infections. In addition to traditional therapies, many parents are looking for herbal or complementary treatment options with a favorable safety profile. Echinacea purpurea has long been used in folk medicine to support the immune system and cushion infections. However, the efficacy and safety of this plant in children is scientifically controversial, which is why this systematic review with meta-analysis summarizes the evidence to date.
Aim of the investigation
The aim was to evaluate the effect and safety of Echinacea purpurea on the treatment of upper respiratory tract infection (URTI) and otitis media in children. For this purpose, several databases (Embase, Cochrane Central, PubMed, ClinicalTrials.gov) were systematically searched for suitable randomized controlled trials published between January 2000 and December 2023.
Methodology
A total of 9 randomized, controlled trials with more than 3,000 participants were included in the meta-analysis. The studies varied in terms of echinacea product (including different extracts and preparations), dosage and duration of use. Methodological quality was assessed using established criteria, with three studies rated as very good, five as good and one as moderate quality. The meta-analysis was conducted according to PRISMA guidelines and using standardized statistical methods.
Results
Effect on upper respiratory tract infections (URTI)
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Reduced frequency of infections: Children who received echinacea were less likely to contract URTI compared to placebo.
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Shorter treatment duration: The duration of the infection was shorter on average in treated children.
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Reduced antibiotic use: Children in the echinacea group needed antibiotics less frequently, which is an important result in terms of conserving antibiotic resources.
These effects were statistically significant.
Effect on inflammation of the middle ear (otitis media)
Echinacea also had an effect on reducing the number of otitis media cases, but showed no clear effect on the duration of the disease, which is probably related to the fact that otitis media often have a bacterial component that may require antibiotic therapy.
Safety and side effects
Overall, Echinacea purpurea was well tolerated. However, the analysis showed a moderate increase in mild side effects (such as gastrointestinal complaints or skin reactions) compared to placebo. Serious adverse events were rare.
Assessment of the study situation
The included studies differed in preparation form, doses and study design, which leads to a certain heterogeneity. In addition, the range of age groups and disease severity studied was different, which makes the transferability of the results somewhat more difficult. Despite these limitations, the consistent trends of the meta-analysis show a clear pattern in favor of Echinacea purpurea in URTI prophylaxis and treatment.
Conclusion
The meta-analysis provides evidence-based indications that Echinacea purpurea in children with upper respiratory tract infection
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reduce the incidence of infection,
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shorten the duration of the disease and
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can reduce the need for antibiotics.
There was also a reduction in episodes of middle ear infections. The results are promising, but the study emphasizes that further high-quality, standardized studies are needed to more clearly define optimal formulations, doses and application periods