Does Echinacea Reduce the Duration and Severity of Colds in Children?
The common ]]>cold]]> is a virus that infects the upper respiratory tract. School-age children are at highest risk of catching a cold. On average, children have 6-8 colds each year. This is no small matter, since these colds last 7-9 days and often require medical attention.
How is a cold treated? While there are over-the counter (OTC) cold medications available, many people turn to alternative remedies to treat a cold. This may be due in part to the fact that the OTC medications are of questionable benefit. One of the most popular remedies, ]]>echinacea]]> , is thought to boost the immune system and help defend the body against colds, sore throats, and the ]]>flu]]> . Results from studies on echinacea and colds have been mixed; while some show that people taking echinacea have shorter and less severe colds, most of these studies have major design flaws. And, until now, no large randomized controlled trial has determined whether echinacea is effective in treating colds in children.
A new study in the December 3, 2003 issue of the Journal of the American Medical Association found that echinacea was no more effective than a placebo in treating cold symptoms in children between the ages of 2-11. The researchers also found that the children taking echinacea were significantly more likely to develop a rash.
About the Study
This study included 524 healthy children between ages 2-11. Children with a history of ]]>asthma]]> , ]]>allergies]]> , ]]>cystic fibrosis]]> , autoimmune disease, and bronchopulmonary dysplasia were excluded because of possible adverse affects associated with echinacea. The researchers were concerned that the possible effects of echinacea on the immune system could potentially harm children with these conditions.
During a four-month study period, the children’s parents were randomly assigned to receive either Echinacea purpurea (a common species of echinacea) or placebo. The parents administered the echinacea or placebo in doses based on manufacturers’ recommendations to their children from the start of a cold until all symptoms had resolved, up to a maximum of 10 days.
The parents rated the severity of four cold symptoms—sneezing, coughing, nasal congestion, and runny nose—in a symptom logbook until all symptoms subsided, for up to 21 days. They also recorded their children’s fever daily. The parents were asked not to administer any medication other than the study medication and acetaminophen (if desired), unless prescribed by a physician.
The researchers compared the duration and severity of colds between the children taking the echinacea and those taking the placebo, and determined whether there were any adverse events associated with taking echinacea.
During the study, parents submitted symptom logbooks for 707 colds experienced by 407 children. Of these colds, 370 had been treated with placebo and 337 with echinacea.
The duration and severity of cold symptoms was no different in the children who took echinacea, compared with the children who took the placebo. The children taking echinacea, however, were significantly less likely to have subsequent colds. Specifically, of the children who had at least one cold, 64% of the children taking the placebo had subsequent cold, while only 52% of the children taking the echinacea had subsequent colds. While this finding is intriguing, this analysis was not planned, and it may have reached significance by chance.
The number of adverse events was not significantly different between the two groups. Significantly more children in the echinacea group, however, developed a rash—7%, compared with 3% in the placebo group. The adverse events were not severe, however. Over 98% of adverse events reported in the echinacea group were categorized as mild or moderate.
How Does This Affect You?
These findings suggest that echinacea is not helpful in treating colds in children. Many people assume that herbal remedies are safe, since they are “natural”. While echinacea was generally well tolerated in this study, the children taking echinacea were more likely to develop a rash, which may have been a symptom of an allergic reaction. There have been reports of severe allergic reactions to echinacea. Echinacea may also cause upset stomach, nausea, and dizziness.
Although the researchers did not set out to show a protective effect for echinacea, they did find that the children who took the herb were significantly less likely to experience recurrent colds. Is it possible that taking echinacea stimulated an immune response in these children that protected them against future colds? Although other research has hinted at this possibility, the findings from this study cannot be used to draw such a conclusion.
Based on the results of this well-designed trial, giving your child echinacea in the hopes of treating their colds is no more effective than giving him or her a placebo. So what can you do to provide your child some relief? How about chicken soup? It will work at least as well as anything else—including, apparently, echinacea.
American Academy of Family Physicians
National Institute of Allergy and Infectious Disease
Beat the winter bugs: how to hold your own against colds and flu. Food and Drug Administration website. Available at: http://www.fda.gov/fdac/features/2001/601_flu.html . Accessed December 4, 2003.
Echinacea: what should I know about it? American Academy of Family Physicians website. Available at: http://familydoctor.org/744.xml . Accessed December 4, 2003.
Taylor JA, Weber W, Standish L, et al. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized trial. Journal of the American Medical Association . 2003;290:2824-2830.
Last reviewed Dec 5, 2003 by ]]>Richard Glickman-Simon, MD]]>
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