 |
|
Efficacy and Safety of Echinacea in Treating Upper Respiratory Tract Infections in Children
A Randomized Controlled Trial
James A. Taylor, MD;
Wendy Weber, ND, MPH;
Leanna Standish, ND, PhD;
Hal Quinn, MD;
Jenna Goesling;
Mary McGann, MPH, MSW;
Carlo Calabrese, ND, MPH
JAMA. 2003;290:2824-2830.
Context Echinacea is a widely used herbal remedy for treatment of upper respiratory tract infections (URIs). However, there are few data on the efficacy and safety of echinacea in treating URIs in children.
Objectives To determine if Echinacea purpurea is effective in reducing the duration and/or severity of URI symptoms in children and to assess its safety in this population.
Design, Setting, and Participants Randomized, double-blind, placebo-controlled trial of healthy children 2 to 11 years old recruited from a regional practice-based network and an alternative medical center in 4-month periods from 2000 through 2002.
Interventions Study patients were randomized to receive either echinacea or placebo for up to 3 URIs over a 4-month period. Study medication was begun at the onset of symptoms and continued throughout the URI, for a maximum of 10 days.
Main Outcome Measures Primary outcomes were duration and severity of symptoms and adverse events recorded by parents; secondary outcomes included peak severity of symptoms, number of days of peak severity, number of days of fever, and a global assessment of severity of symptoms by parents of study children.
Results Data were analyzed on 707 URIs that occurred in 407 children, including 337 URIs treated with echinacea and 370 with placebo. There were 79 children who completed their study period without having a URI. The median duration of URIs was 9 days (95% confidence interval, 8-10 days); there was no difference in duration between URIs treated with echinacea or placebo (P = .89). There was also no difference in the overall estimate of severity of URI symptoms between the 2 treatment groups (median, 33 in both groups; P = .69). In addition, there were no statistically significant differences between the 2 groups for peak severity of symptoms (P = .68), number of days of peak symptoms (1.60 in the echinacea group and 1.64 in the placebo group; P = .97), number of days of fever (0.81 in the echinacea group vs 0.64 in the placebo group; P = .09), or parental global assessment of severity of the URI (P = .67). Overall, there was no difference in the rate of adverse events reported in the 2 treatment groups; however, rash occurred during 7.1% of the URIs treated with echinacea and 2.7% of those treated with placebo (P = .008).
Conclusions Echinacea purpurea, as dosed in this study, was not effective in treating URI symptoms in patients 2 to 11 years old, and its use was associated with an increased risk of rash.
Author Affiliations: Child Health Institute, University of Washington and Children's Hospital and Regional Medical Center, Seattle, Wash (Dr Taylor); Department of Naturopathic Medicine, Bastyr University, Kenmore, Wash (Drs Standish and Weber, and Mss Goesling and McGann); Mercer Island Pediatric Associates, Mercer Island, Wash (Dr Quinn); and Helfgott Research Institute, National College of Naturopathic Medicine, Portland, Ore (Dr Calabrese).
RELATED LETTERS
Echinacea for Treating Colds in Children
Linda Kim, Debra Wollner, Paul Anderson, and Debra Brammer
JAMA. 2004;291(11):1323.
EXTRACT
| FULL TEXT
Echinacea for Treating Colds in Children
Fabio Firenzuoli and Luigi Gori
JAMA. 2004;291(11):1323-1324.
EXTRACT
| FULL TEXT
Echinacea for Treating Colds in Children—Reply
James A. Taylor, Wendy Weber, Leanna Standish, Mary McGann, and Carlo Calabrese
JAMA. 2004;291(11):1324.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Safety and Tolerability of North American Ginseng Extract in the Treatment of Pediatric Upper Respiratory Tract Infection: A Phase II Randomized, Controlled Trial of 2 Dosing Schedules
Vohra et al.
Pediatrics 2008;122:e402-e410.
ABSTRACT
| FULL TEXT
Complementary Therapies and Integrative Oncology in Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition)
Cassileth et al.
Chest 2007;132:340S-354S.
ABSTRACT
| FULL TEXT
Nonprescription Medication Use by Infants and Children: Product Labeling Versus Evidence-Based Medicine
Orr et al.
Journal of Pharmacy Practice 2006;19:286-294.
ABSTRACT
Echinacea
Charrois et al.
Pediatr. Rev. 2006;27:385-387.
FULL TEXT
Does treatment with Echinacea purpurea effectively shorten the course of upper respiratory tract infections in children?
Koenig and Roehr
Arch. Dis. Child. 2006;91:535-537.
FULL TEXT
Complementary and alternative medicine for upper-respiratory-tract infection in children
Carr and Nahata
Am J Health Syst Pharm 2006;63:33-39.
ABSTRACT
| FULL TEXT
Studying Herbal Remedies
Sampson
NEJM 2005;353:337-339.
FULL TEXT
An Herbal Combination that Prevents Common Infections in Children?
Paul
AAP Grand Rounds 2004;12:5-5.
FULL TEXT
Echinacea for Treating Colds in Children
Kim et al.
JAMA 2004;291:1323-1323.
FULL TEXT
Echinacea for Treating Colds in Children
Firenzuoli and Gori
JAMA 2004;291:1323-1324.
FULL TEXT
Echinacea does not improve cold symptoms
Kemp
AAP News 2004;24:108-108.
FULL TEXT
Echinacea Not Found Efficacious for Treatment of URI Symptoms
Dubik
AAP Grand Rounds 2004;11:17-17.
FULL TEXT
Echinacea No Help for URIs in Children
JWatch Emergency Med. 2004;2004:10-10.
FULL TEXT
Echinacea Not Effective Against URIs in Children
JWatch Infect. Diseases 2004;2004:8-8.
FULL TEXT
Echinacea Isn't Effective for Children with URIs
JWatch Pediatrics 2004;2004:8-8.
FULL TEXT
Echinacea Not Effective for URIs in Children
JWatch General 2004;2004:4-4.
FULL TEXT
|
