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Echinacea root extracts for the prevention of upper respiratory tract infections: a double-blind, placebo-controlled
D Melchart1, E Walther, K Linde
1Center for Complementary Medicine Research, Technische Universität, Munich, Germany. Muenchener.Modell@lrz.uni-muenchen.de
Objective:
To investigate the safety and efficacy of 2 extracts of echinacea for preventing upper respiratory tract infections.
Design:
Three-armed, randomized, double-blind, placebo-controlled trial.
Setting:
Four military institutions and 1 industrial plant.
Participants:
Three hundred two volunteers without acute illness at time of enrollment.
Interventions:
Ethanolic extract from Echinacea purpurea roots, Echinacea angustifolia roots, or placebo, given orally for 12 weeks.
Main Outcome Measure:
Time until the first upper respiratory tract infection (time to event). Secondary outcome measures were the number of participants with at least 1 infection, global assessment, and adverse effects.
Results:
The time until occurrence of the first upper respiratory tract infection was 66 days (95% confidence interval [CI], 61-72 days) in the E angustifolia group, 69 days (95% CI, 64-74 days) in the E purpurea group, and 65 days (95% CI, 59-70 days) in the placebo group (P = .49). In the placebo group, 36.7% had an infection. In the treatment groups, 32.0% in the E angustifolia group (relative risk compared with placebo, 0.87; 95% CI, 0.59-1.30) and 29.3% in the E purpurea group (relative risk compared with placebo, 0.80; 95% CI, 0.53-1.31) had an infection. Participants in the treatment groups believed that they had more benefit from the medication than those in the placebo group (P = .04). Adverse effects were reported by 18 subjects in the E angustifolia group, 10 in the E purpurea group, and 11 in the placebo group.
Conclusion:
In this study a prophylactic effect of the investigated echinacea extracts could not be shown. However, based on the results of this and 2 other studies, one could speculate that there might be an effect of echinacea products in the order of magnitude of 10% to 20% relative risk reduction. Future studies with much larger sample sizes would be needed to prove this effect.