Herbal medicines are particularly regarded as an alternative or complement to conventional pharmaceuticals in the treatment and prevention of respiratory tract infections (RTI).
Therefore the purpose of this review was to identify evidence for herbal therapy in the treatment of RTI concerning effectiveness and safety.
Medline/PubMed, Scopus and the Cochrane Library were searched through 12 February 2015.
Randomized controlled trials comparing herbal therapy with no treatment, placebo or any pharmaceutical medication in children and adolescents (age 0 to 18 years) with RTI were eligible.
Eleven trials with 2,181 participants were included. No clear evidence for Echinacea (4 trials) or an herbal compound preparation (1 trial) in preventing RTI symptoms was found. Meta-analysis revealed evidence for efficacy (responder rates: risk ratio [RR] = 2.56; 95% confidence interval [CI], 1.54 to 4.26; P < 0.01; heterogeneity: I(2) = 38%; χ(2) = 9.63; P = 0.14) and safety (patients with adverse events: RR = 1.06; 95% CI, 0.42 to 2.66; P = 0.9; heterogeneity: I(2) = 72%; χ(2) = 10.64; P = 0.01) of Pelargonium sidoides in treating respiratory tract infection symptoms compared to placebo (6 trials).
Due to conflicting evidence in the included studies no concrete conclusion on effects of Echinacea could be drawn so far. In the case of Pelargonium sidoides, performed meta-analysis revealed moderate evidence for efficacy and safety in the treatment of respiratory tract infections in children.