Reduced antibiotic use after initial treatment of acute respiratory infections with phytopharmaceuticals- a retrospective cohort study

Abstract

Objectives: We examined the relationship between the initial treatment of acute lower and upper tract respiratory infections with phytopharmaceuticals and the duration of the disease as well as between the initial treatment and the use of antibiotics in the further course of the disease. Method: Outpatients from the IMS® Disease Analyzer database with diagnoses of acute respiratory infections between January 2015 and March 2019 were observed for 30 days. Patients who had been prescribed phytopharmaceuticals on the day of their diagnosis were matched with controls who had not received such prescriptions by treating practice, diagnosis, age, sex, insurance status, index year, and Charlson comorbidity score. Patients antibiotic precriptions on the day of diagnosis were excluded. Logistic regression was used to investigate the relationship between phytopharmaceutical prescription, antibiotic prescription in the further course of the disease, and duration of sick leave. Results: A total of 117,182 patients who had been prescribed phytopharmaceuticals and an equal number of controls were available for analysis. Phytotherapeutics were associated with fewer antibiotic prescriptions. Extract of Pelargonium sidoides root (odds ratio (OR) 0.49 [0.43-0.57]) and thyme extract (OR 0.62 [0.49-0.76]) exhibited the strongest effect among patients treated by general practitioners, while Pelargonium sidoides root extract (OR 0.57 [0.38-0.84]), thyme and ivy extract (OR 0.66 [0.60-0.73]), and thyme and primrose root extract (OR 0.67 [0.47-0.96]) proved most effective in pediatric patients. Patients receiving phytopharmaceuticals had a significantly lower risk of prolonged periods of sick leave. The risk of sick leave durations of >7 days was most markedly reduced in patients taking cineole (OR 0.74 [0.63-0.86]) and Pelargonium root extract (OR 0.79 [0.54-0.96]). Conclusion: The use of selected phytopharmaceuticals for acute respiratory infections is associated with a significantly reduced need for antibiotic prescriptions in the further course of the disease, as well as significantly shorter sick leaves.

The effects of Hedera helix on viral respiratory infections in humans: A rapid review

“…The thirteen included studies consisted of five observational studies [ 3 , 4 , 6 , 7 , 20 ], four randomised controlled trials [ 9 , 13 , 21 , 22 ], two open-label trials [ 23 , 24 ], one controlled clinical trial [ 25 ] and one retrospective analysis of case notes [ 26 ]. Two studies were reported as double-blind [ 9 , 22 ], two as single-blind [ 13 , 21 ], and two as open-label [ 23 , 24 ].…”

“…Studies were conducted across two World Health Organisation (WHO) regions [ 27 ]. The three trials conducted in the Eastern Mediterranean Region were all conducted in Pakistan [ 13 , 21 , 25 ]; the remaining ten trials were conducted in the European region, specifically in Germany [ 3 , 6 , 9 , 22 , 26 ], Slovenia [ 7 ], Switzerland [ 4 , 23 ], and Russia [ 20 , 24 ].…”

“…The thirteen included studies comprised a total pool of 210,481 participants, with sample sizes ranging between 36 and 173,226. Five studies recruited children only (with ages ranging between one month and 18 years [ 3 , 6 , 7 , 20 , 24 ], three studies recruited adults only (aged ≥18 years) [ 22 , 23 , 26 ], and four studies recruited both adults and children (aged ≥2 years) [ 4 , 9 , 13 , 21 ]; one study [ 25 ] did not describe the sample. Conditions under investigation varied from bronchitis (n = 3) [ 3 , 4 , 9 ], to non-specific respiratory tract infection symptoms (i.e.…”

“…Conditions under investigation varied from bronchitis (n = 3) [ 3 , 4 , 9 ], to non-specific respiratory tract infection symptoms (i.e. cough n = 2) [ 21 , 22 ], respiratory tract infection (n = 4) [ 7 , 13 , 24 , 26 ], non-specific inflammatory airway disease (n = 2) [ 6 , 23 ] and bronchial obstruction-syndrome (n = 1) [ 20 ]; one study [ 25 ] did not describe the presenting condition. One study included both acute bronchitis and chronic bronchitis, as well as other chronic respiratory diseases with intense formation of viscous mucous [ 23 ].…”

“…Hedera helix was administered in oral form in all thirteen studies, with seven studies [ 3 , 4 , 6 , 7 , 9 , 20 , 22 ] using a single-herbal formulation and six studies [ 13 , 21 , [23] , [24] , [25] , [26] ] using a multi-herbal formulation. The intervention was administered most frequently in syrup form (n = 4) [ 4 , 7 , 21 , 24 ], followed by tablet (n = 1) [ 25 ], ethanolic extract (n = 1) [ 22 ], drop [ 9 ] and granulated [ 13 ] forms.…”