Does additional antimicrobial treatment have a better effect on URTI cough resolution than homeopathic symptomatic therapy alone? A real-life preliminary observational study in a pediatric population

Abstract

BackgroundThe effectiveness of a homeopathic syrup on cough has been demonstrated in an adult population in a previous double-blind randomized study. The present prospective observational study investigated children affected by wet acute cough caused by non-complicated URTIs, comparing those who received the homeopathic syrup versus those treated with the homeopathic syrup plus antibiotic.ObjectivesThe aims were: 1) to assess whether the addition of antibiotics to a symptomatic treatment had a role in reducing the severity and duration of acute cough in a pediatric population, as well as in improving cough resolution; 2) to verify the safety of the two treatments.MethodsEighty-five children were enrolled in an open study: 46 children received homeopathic syrup alone for 10 days and 39 children received homeopathic syrup for 10 days plus oral antibiotic treatment (amoxicillin/clavulanate, clarithromycin, and erythromycin) for 7 days. To assess cough severity we used a subjective verbal category-descriptive (VCD) scale.ResultsCough VCD score was significantly (P < 0.001) reduced in both groups starting from the second day of treatment (−0.52 ± 0.66 in the homeopathic syrup group and −0.56 ± 0.55 in children receiving homeopathic syrup plus oral antibiotic treatment). No significant differences in cough severity or resolution were found between the two groups of children in any of the 28 days of the study. After the first week (day 8) cough was completely resolved in more than one-half of patients in both groups. Two children (4.3 %) reported adverse effects in the group treated with the homeopathic syrup alone, versus 9 children (23.1 %) in the group treated with the homeopathic syrup plus antibiotics (P = 0.020).ConclusionsOur data confirm that the homeopathic treatment in question has potential benefits for cough in children as well, and highlight the strong safety profile of this treatment. Additional antibiotic prescription was not associated with a greater cough reduction, and presented more adverse events than the homeopathic syrup alone.

Survey on attitudes of Italian pediatricians toward cough

“…Although the recognized lack of efficacy for this therapeutic strategy, neither in common cold nor in viral infections,29–31 the rates of prescription proved very high in the present survey. There was an excessive use of antibiotics in acute cough, particularly in allergic rhinitis/asthma (41%) and URTIs (17%).…”

“…First, the question about the causes of cough can lead to some misinterpretations, because respondents mainly indicated a general etiology for cough rather than a specific disease. For instance, several pediatricians reported allergy as a general cause of cough, while a more detailed definition of the allergy-related diseases, such as asthma, rhinitis, and eosinophilic bronchitis, would have allowed a more precise cough etiology 31–41…”

The Effectiveness and Safety of a Homeopathic Medicinal Product in Pediatric Upper Respiratory Tract Infections With Fever

“… 31 The current trial evidence in children on the homeopathic treatment of URTI concerns the prevention of URTI 32 - 35 and the treatment of chronic recurrent URTI. 36 Moreover, there exists evidence for the treatment of other conditions that can include URTI, 37 - 40 and some non–controlled studies are available that contain promising data on the treatment of chronic URTI, 41 cough, 42 and the safety of a complex homeopathic medicine in the treatment of acute respiratory tract infections. 43 A comparative cohort study conducted in France showed that homeopathically managed patients with URTI had significantly lower consumption of antibiotics compared to conventionally managed patients, while achieving comparable clinical outcomes, 44 pointing to potential benefits from a health economic perspective and to decrease the public health risk related to antibiotic resistance.…”

Food and Drug Administration Action Against Homeopathic Teething Tablets Lacked Evidence Base

“…A study on a homeopathic cough syrup with or without additional antibiotics demonstrated that the antibiotics added no therapeutic value yet added unwanted side effects 53 ; coughs, although often viral in nature, are a leading reason why antibiotics are prescribed in the United States. A study in France, where people can choose a conventional or homeopathic pediatrician or primary-care doctor, comparing children offered homeopathic or conventional treatment for recurrent colds found that the former had fewer recurrences, fewer complications, and better quality of life, and the parents needed fewer sick-leave days.…”