Colds and flu

16 July 2014

Echinacea ineffective for childhood colds

Echinacea, one of the most common herbal remedies, was found not to be effective in treating upper respiratory tract infections in children.

Echinacea is not effective in shortening the duration or decreasing the severity of upper respiratory tract infections in children, according to a study in The Journal of the American Medical Association (JAMA).

Upper respiratory tract infections a burden

Upper respiratory tract infections (URIs) are a significant health burden in childhood. The average child has six to eight colds each year, each lasting seven to nine days.

While children are frequently given drugs such as decongestants, antihistamines, and cough suppressants to reduce symptoms, there is little evidence that these medications are effective in children younger than 12 years.

The authors add that it has been estimated that 11 percent to 21 percent of children in the United States and Canada who are receiving care from conventional physicians are also using alternative therapies. Echinacea, one of the most commonly used herbal remedies in the US, has been used extensively for the prevention and treatment of URIs in adults.

Read: Causes and red flags of acute cough

Randomised trial

James A. Taylor, M.D., from the University of Washington, Seattle, and colleagues, conducted a randomised controlled trial to determine the effectiveness and safety of Echinacea purpurea (a type of echinacea used for medicinal purposes) in treating URIs in children two to 11 years old.

A total of 524 children were included in the study. The patients were randomised to receive either echinacea or placebo for up to three URIs over a four-month period. The echinacea or placebo was started at the onset of symptoms and continued for a maximum of ten days.

Data were analyzed on 707 URIs that occurred in 407 children, including 337 who were treated with echinacea and 370 with placebo. There were 79 children who completed the study period without getting a URI. The median (half were more; half were less) duration of the URIs was 9 days.

No difference

"There was no difference in duration between upper respiratory tract infections treated with echinacea or placebo," the authors report. "There was also no difference in the overall estimate of severity of upper respiratory tract infection symptoms between the two treatment groups (median, 33 in both groups).

In addition, there were no statistically significant differences between the two groups for peak severity of symptoms, number of days of peak symptoms (1.60 in the echinacea group and 1.64 in the placebo group), number of days of fever (0.81 in the echinacea group vs. 0.64 in the placebo group), or parental global assessment of severity of the upper respiratory tract infection."

The authors note there was no difference in the rate of adverse events (unwanted side effects) reported in the two treatment groups. However, rashes occurred during 7.1 percent of the upper respiratory tract infections treated with echinacea and 2.7 percent of those treated with placebo.

Read: Doctors prescribing placebo

"Given its lack of documented efficacy and an increased risk for the development of rash, our results do not support the use of echinacea for treatment of URIs (upper respiratory tract infections) in children 2 to 11 years old.

Further studies using different echinacea formulations, doses, and dosing frequencies are needed to delineate any possible role for this herb in treating colds in young patients," the authors conclude.

Read more:

Coughs don't respond to antibiotics
Identify your child's cough


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Flu expert

Dr Heidi van Deventer completed her MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 2004 at the University of Stellenbosch.
She has additional training in ACLS (Advanced Cardiac Life Support) and PALS (Paediatric Advanced Life Support) as well as biostatistics and epidemiology.

Dr Van Deventer is currently working as a researcher at the Desmond Tutu Tuberculosis Centre at the University of Stellenbosch.

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