Homeopathic medicinal products for acute respiratory tract infections in children

To read the full review go to: Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children

Plain language summary

What are the benefits and risks of oral homeopathic medicines in preventing and treating acute respiratory tract infections in children?

Key messages

Homeopathy is a type of complementary and alternative medicine. It is based on two main ideas: that substances that may cause illness or symptoms in a healthy person can, in very small doses, treat those symptoms in a person who is unwell; and that molecules in highly diluted substances retain a memory of the original substance. Due to a lack of solid evidence, the benefits and risks of oral homeopathic medicines for preventing and treating acute respiratory tract infections (ARTIs) in children are unclear. Studies of lower quality in design and reporting often suggest a possible benefit for oral homeopathic medicines, but studies of higher quality do not find benefit.

What are respiratory tract infections?

Respiratory infections are commonly caused by viruses, especially colds and influenza, though some lung and ear infections are caused by bacteria. It may be difficult to tell these infections apart, and sometimes they occur together. Most such infections improve without treatment, but sometimes symptoms persist after the initial infection has gone. Treatment is therefore aimed at relieving symptoms.

Why is this important in children?

Children have on average three to six respiratory tract infections each year. Although most are mild and treatable, they are sometimes acute (serious, swift, or sudden onset) respiratory tract infections that may require hospital treatment, but very rarely result in death.

How are ARTIs treated?

Antibiotic medicines taken orally (by mouth/swallowed, usually in the form of a tablet, pill, lozenge, or liquid) are often prescribed for ARTIs, even though they are ineffective against viruses. Homeopathic medicines may treat ARTIs with few side effects, but their effectiveness and safety has not been well researched.

What did we want to find out?

We wanted to know whether homeopathic medicines help children with ARTIs. We were interested in the effect of homeopathic medicines compared to placebo (a 'dummy' treatment that does not contain any medicine but looks or tastes identical to the medicine being tested) or to usual care therapies for ARTIs.

We were also interested in the effect of homeopathic medicines on improvement in the severity or symptoms of infection, the need for antibiotics, duration of illness (that would affect days off school or days off work for parents), symptom reappearance, and any medicine adverse effects.  

What did we do?

We searched for randomised controlled trials (studies where people are randomly assigned to one of two or more treatment groups) that investigated whether oral homeopathic medicines, compared to placebo or usual care ARTI therapies, were effective in the prevention or treatment of ARTIs in children aged up to 16 years. We compared and summarised the results of the studies, and rated our confidence in the evidence based on factors such as study methods and number of participants.

What did we find?  

We found 11 studies involving 1813 children (5 studies for prevention and 6 studies for treatment of ARTIs). All studies investigated upper respiratory tract (from the nose to the windpipe (trachea)) infections, but one study combined reporting of upper and lower respiratory tract (from the windpipe to the lungs and pleura (membranes covering the lungs)) infections, so the numbers of children with upper or lower ARTIs is unknown.

Main results

In the treatment or prevention of ARTIs in children, homeopathic medicines showed little or no beneficial effects, whether individualised by a trained homeopath or a standard commercially available homeopathic therapy (11 studies, 1813 children).

Where results could be combined, there was little or no difference between groups for short‐term cure (2 studies, 155 participants) or long‐term cure (2 studies, 155 participants), but the evidence is very uncertain. There may be little or no difference between groups for prevention of ARTI (3 studies, 735 participants).

There was no important difference between homeopathy and placebo groups for parents' time off work, antibiotic use, or adverse events. We are unsure about the safety of homeopathic medicines because data on adverse events were poorly reported. Overall, the findings of this review do not support the use of homeopathic medicinal products for ARTIs in children.

What are the limitations of the evidence?

We have little confidence in the evidence because the studies involved only small numbers of children, used different types of homeopathic medicines for various ARTIs, contained numerous biases, and failed to report information about important outcomes. Further research could provide results that differ from the results of this review.

How up‐to‐date is this evidence?

The evidence is current to 16 March 2022.