THE ROLE OF COMPLEMENTARY AND

ALTERNATIVE MEDICINE (CAM) IN REDUCING

THE PROBLEM OF ANTIMICROBIAL RESISTANCE

THE ROLE OF COMPLEMENTARY AND

ALTERNATIVE MEDICINE (CAM) IN REDUCING

THE PROBLEM OF ANTIMICROBIAL RESISTANCE

eurocamrue du trône 1941050 brusselsbelgiumt: +32 2 644 00 20e: info@cam-europe.eu

This document reflects the position of EUROCAM, the alliance of European umbrella organisations of

patients, physicians and practitioners in the field of Complementary and Alternative Medicine (CAM).

The following European umbrella organisations work together in EUROCAM:

Association for Natural Medicine in Europe - ANME

European Ayurveda Association - EUAA

European Ayurveda Medical Association - EURAMA

European Central Council of Homeopaths - ECCH

European Committee for Homeopathy - ECH

European Council of Doctors for Plurality in Medicine - ECPM

European Federation of Homeopathic Patients’ Associations - EFHPA

European Federation of Osteopaths - EFO

European Federation of Patients’ Organisations for Anthroposophic Medicine - EFPAM

European Herbal & Traditional Medicine Practitioners Association - EHTPA

European Traditional Chinese Medicine Associations - ETCMA

International Council of Medical Acupuncture and Related Techniques - ICMART

International Federation of Anthroposophic Medical Associations - IVAA

The objective of EUROCAM is to promote and facilitate CAM’s role in maintaining citizens’ health,

highlight the health promotion and illness prevention aspects of CAM for EU public health policy

and programmes, to advance the accessibility, affordability and availability of CAM, and generally

promote CAM at European level.

2nd edition

brussels, november 2015

TABLE OF CONTENTS

1 INTRODUCTION - 5

2 THE ROLE OF CAM IN INCREASING THE RESILIENCE OF INDIVIDUALS - 6

3 HERBAL MEDICINE IN HUMANS - 7

4 HOMEOPATHIC MEDICINE IN HUMANS - 9

5 ANTHROPOSOPHIC MEDICINE - 10

6 ANTIBIOTICS IN THE FARMING INDUSTRY - 12

7 RECENT POLICY OF THE EUROPEAN COMMISSION IN ORGANIC FARMING - 12

8 HERBAL MEDICINE IN ANIMAL HUSBANDRY - 13

9 HOMEOPATHIC MEDICINE IN ANIMAL HUSBANDRY - 14

10 CONCLUDING REMARKS AND SUGGESTIONS - 16

• • TABLE 1

Herbs to help combat growing antibiotic resistance - 18

• TABLE 2

Homeopathy in upper and lower respiratory tract infections - 20

• TABLE 3

Anthroposophic medicine in upper and lower respiratory tract infections - 23

• TABLE 4

Homeopathy in animals with infectious diseases - 24

• REFERENCES - 27

3

4

1 INTRODUCTION

Antimicrobial resistance (AMR) - the resistance of bacteria, parasites, viruses and fungi to antimicro-

bial drugs previously effective for treatment of infections they caused – is now a serious worldwide threat

to public health. Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security recently said that

AMR is occurring in every region of the world, potentially affecting anyone, of any age, in any country. He

warned that, if measures were not taken immediately to counter AMR, the implications will be devastat-

ing. Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic

era, in which common infections and minor injuries which have been treatable for decades can once again

kill’.a In the light of this, this paper describes how the sector of Complementary and Alternative Medicine

(CAM) can make a significant contribution to reducing the problem of AMR.

The CAM perspective on health and disease is essentially different from the conventional biomedical

perspective. It is not just a difference in the technology and instruments used, but in the underlying para-

digms, basic concepts and philosophical perspective. Although CAM represents a variety of different

medical systems and therapies, the CAM modalities have a common denominator, i.e. their individualised

holistic approach and their focus on promoting the individual’s health by assisting the person’s innate

self-healing and health-maintaining capacity.

The CAM perspective on infectious disease also differs from the biomedical one. A short retrospective of

the different scientific positions in the 19th century on the role of pathogens in infectious disease is helpful

to understand this.

The German physician Robert Koch (1843-1910) argued that bacteria are the smallest but most dan-

gerous enemies of mankind. His critic Max Josef von Pettenkofer (1818-1901) a chemist and hygienist,

maintained that pathogens infect only the most susceptible (those with poor diet, constitution, etc.) and,

proving his point, he drank a large cholera cocktail without falling ill.

In France a similar controversy existed between Louis Pasteur and Claude Bernard.

Louis Pasteur (1822-1885), a chemist and microbiologist, took the position that microorganisms infecting

animals and humans cause disease. Physiologist Claude Bernard (1813-1878) argued on the other hand

that the body becomes susceptible to infectious agents only if the internal balance – or homeostasis as

we now call it – is disturbed. After all, there are billions of microbes and bacteria inhabiting our gut, our

blood, in fact our whole system most of which are essential to good health. Pathological bacteria, fungi and

viruses take root as disease when the terrain is weakened and susceptible to them. This explains why when

a bacterial or viral agent is “doing the rounds,” some people become sick while others remain healthy.

History shows that the perspectives of Pasteur and Koch that focused on combating disease by directly

killing germs have prevailed. There is no question that antibiotics have dramatically and successfully

reduced illness and death from serious infectious diseases. However, the vital role of the host’s ability to

repel invaders based on a properly functioning immune system, has been neglected. In reality, infection

is always the result of two factors: exposure to a pathogen and the person’s susceptibility.

a - World Health Organisation, 2014. WHO’s first global report on antibiotic resistance reveals serious, worldwide threat to public health.

Available from: http://www.who.int/mediacentre/news/releases/2014/amr-report/en/

5

This one-eyed approach which focuses only on the infecting organism is also reflected in research, which

has been directed at finding the most potent way to kill the germs, whereas hardly any research investigates

ways and means to raise the effectiveness of the immune system.

In fact, both approaches have their merits. In a patient who is seriously ill and affected by highly virulent

bacteria, there is no argument, that antibiotics can be live saving. On the other hand, antibiotics do not offer

an adequate solution for a patient who has had recurrent infections and taken several courses of antibiotics,

because in this case it is the patient’s susceptibility that needs to be addressed.

Lastly there is a growing awareness of the importance to health of the microbiome - the collective genomes

of the microbes (composed of bacteria, bacteriophage, fungi, protozoa and viruses) that live inside and

on the human body. The human body has about 10 times as many microbial cells as human cells. The

microbiome plays an essential part in the immune system protecting us against infection, breaking down

food in the digestive system to release energy and producing vitamins and helping in the elimination of

waste. What is also now being understood is that antibiotics can have a disrupting and disturbing effect

on the microbiome and may be causatively involved in a number of the widespread chronic illnesses that

currently affect us such as obesity, diabetes and cancer, e.g. a recent study revealed a connection between

early antibiotic exposure in infants and the development of a tendency to obesity by the age of threeb.

A large population-based study carried out in Finland showed a clear statistical correlation between the

level of antibiotic exposure in early life and the likely development of cancer later in lifec.

This growing awareness of how the microbiome is impacted by antibiotics adds another extremely

important reason for why antibiotic use must be dramatically reduced to when they are absolutely es-

sential. It also calls for other ways to treat and prevent illness that support and strengthen the health

and resilience of the terrain of the microbiome which is being increasing understood to be so essential

to our immune system and health generally.

2 THE ROLE OF CAM IN INCREASING THE RESILIENCE OF INDIVIDUALS

When it comes to the host’s ability to repel invaders, basic requirements to keep the immune system

strong include quality sleep, regular exercise, healthy food, relaxation practice and healthy relationships.

In building and maintaining resistance to infectious illness, CAM therapies have an important role to

play because they mobilise and stimulate the self-regulating capacity of the organism, thus increasing its

resilience.

Greater resilience means:

• a swift and sustained recovery from infections;

• a reduced susceptibility to future infections;

• less reliance on antibiotics.

Moreover, herbal medicinal products in particular, as used in CAM, can be used as an alternative means to

fight infection based on their own antimicrobial properties.

b - Trasande L et al (2013). Infant antibiotic exposures and early-life body mass. International Journal of Obesity (London), 37(1):16-23

c - Kilkkinen A et al. (2008). Antibiotic use predicts an increased risk of cancer. International Journal of Cancer, 123(9):2152-2155

6

The following sections describe the role herbal, homeopathic and anthroposophic medicine and their

associated medicinal products can play to reduce the problem of antimicrobial resistance both in humans

and animals. These strategies to reduce our reliance on antibiotics or to make antibiotics that have now

lost their efficacy viable once again, are backed by convincing research.

Below we provide tables reviewing some promising evidenced-based research on herbal, anthroposophic

and homeopathic medicines demonstrating their potential to help combat the growing threat of antibiotic

resistance. This presentation is a selective review illustrating the way in which these medicines might make

a useful contribution; it is not a completely comprehensive and systematic evaluation of the evidence. To

produce this review searches were performed in October 2013 in AltHealthWatch, AMED, Embase, Estar,

Cinahl, the Cochrane Library and PubMed.

To provide a practical evaluation of the evidence presented in this review we have adapted a version of the

widely used GRADE approach (Grades of Recommendation, Assessment, Development and Evaluation)1.

This allows for 4 levels of rating of the research evidence - High/Strong, Moderate, Low and Very Low. For

simplicity, we have amalgamated Low and Very Low grades into a single category of Preliminary evidence.

This selective review highlights potentially fruitful areas for future research.

3 HERBAL MEDICINE IN HUMANS

Herbal medicine – also called botanical medicine, phytomedicine or phytotherapy – refers to using

a plant’s seeds, berries, roots, leaves, bark, or flowers at therapeutic doses in the maintenance of optimal

health, and in the treatment and prevention of disease. Whole herbs contain many chemical constituents

working synergistically together to treat disease and support the body’s own healing mechanisms (e.g. its

immunity).

Herbal medicines may play a role as autonomous anti-bacterial agents or as adjuvant treatments used to

potentiate conventional drugs. This section selectively reviews the evidence for herbal medicine as a valu-

able resource to combat bacterial resistance to antibiotics and suggests that further research is warranted.

Synergy is an important characteristic determining the medicinal action of many herbal medicines oc-

curring at pharmacodynamic and pharmacokinetic levels2, 3 and a number of papers have been published

investigating potential benefits conferred by the synergism of phytoconstituents4, 5, 6, 7. In particular, re-

searchers have demonstrated that combining antibiotics with plant medicines can enhance the action of

antibiotics thereby overcoming antibiotic resistance8.

This is achieved in three main ways: firstly by means of a combined phytochemical and antibiotic attack on

the bacterial cell wall - epigallocatechin gallate (EGCG) as found in green tea and carob powder is effective

in this regard. Secondly, antibiotic resistance can be overcome by inhibition of enzymes that are generated

by bacteria for the deactivation of antibiotics (again EGCG is active here) or, thirdly, by disabling an efflux

pumping system developed by several bacteria in order to prevent potentially destructive compounds such

as antibiotics from penetrating into the bacteria, or to expel the antibiotics out of the bacterial cell once

they have invaded it9, for example the flavonoids in Hydrastis canadensis. Further examples are that thymol

and carvacrol, two compounds in the essential oil of thyme (Thymus vulgaris), act as so-called ‘membrane

permeabilizers’ enabling antibiotics to penetrate into Gram-negative bacteria10. Thyme contains also

contains baicalein also present in the Scutellaria species (Lamiaceae family) and baicalein has shown

significant ability to reverse MRSA resistance to the antibiotic ciprofloxacin by inhibiting the bacteria’s

defensive efflux pump11.

7

Most research to find agents to support antibiotics which have become ineffective against common bac-

teria has been lab-based rather than on humans. A recent review provided evidence of 34 different herbs

containing constituents known to inhibit the bacterial efflux pumps12. For example, E. coli is currently dem-

onstrating resistance to several antibiotics but, combined with extracts of Sophora alopecuroides, isolates of

the bacteria were found susceptible to ciprofloxacin13. Similarly, Klançnik et al. (2013) found that extracts

of Rosmarinus officinalis inhibited drug resistant strains of Campylobacter14. Extracts from several other plants

in this study, have shown similar inhibitory effects on Campylobacter, as have extracts of green tea15.

Another major concern is the drug resistant bacterium, Methicillin-resistant Staphylococcus aureus (MRSA).

Exposure to berberine, a compound found in many medicinal plants (e.g. Coptis chinensis and Phellodendron

amurens) together with antibiotics such as levofloxacin and azithromycin16 (which had recently proved

ineffective against MRSA), resulted in the reactivation of the efficacy of the antibiotic drugs. Similar re-

sults were found employing Scutellaria baicalensis against Staphylococcus aureus to restore the antibacterial

actions of ciprofloxacin via similar mechanisms of efflux pump inhibition17. Indirubin, extracted from the

leaves of Wrightia tinctoria, used in Ayurvedic medicine, has also been found to have an inhibitory effect on

Staphylococcus aureus18. Nineteen herbs commonly used in Chinese medicine have inhibitory effects of which

Dendrobenthamia capitata, Elsholtzia rugulosa, Elsholtzia blanda, Geranium strictipes, Polygonum multiflorum offer

promising anti-MRSA possibilities19. Zuo et al. investigated the antimicrobial effects of 30 plants tradi-

tionally used to treat skin infection focusing on their potential to inhibit Staphylococcus aureus. Of these, 21

extracts were found to have anti-MRSA effects with Mallotus yunnanensis and Skimmia arborescens being the

most active20.

Herbal medicines may help to resolve the problem of antibiotic resistance more directly. Doctors faced

with relatively minor, often self-limiting, but common infections e.g. pharyngitis, laryngitis and ton-

sillitis or mild urinary tract infections (UTIs) have little to offer except advice on how to manage

the condition or otherwise prescribe an antibiotic which may not be appropriate.

Herbal medicines may fill this therapeutic gap, providing effective treatment that reduces antibiotic pre-

scribing and does not contribute to microbial resistance. For example, a number of herbal medicines are

traditionally used to treat sore throat such as sage (Salvia officinalis)21,22, dyers woad (Isatis tinctoria)23, echi-

nacea (Echinacea purpurea or angustifolia)24,25 and burdock (Arctium lappa)26,27. Herbal medicine can also help

to ease UTIs employing remedies such as Arctostaphylos uva ursi28,29,30,31 and Zea mays32. Nigella sativa shows

promise in treating drug resistant H-pylori (see Table 1, page 18).

Several studies suggest that certain Indian and Chinese medicinal plants used in Ayurvedic medicine33,34,35,36

and traditional Chinese medicine37 respectively have significant antimicrobial activity. The systems of

herbal medicine that developed in India and China differ in several significant ways from European herbal

medicine. The most obvious difference is that the Western herbal tradition often, but not always, focuses

on ‘simples’, that is a single herb taken by itself. In contrast, traditional Indian (Ayurvedic) and traditional

Chinese herbal medicine (TCHM) make almost exclusive use of herbal combinations. More importantly,

these formulas are not designed to treat symptoms of a specific illness; rather, they are tailored specifi-

cally to the individual according to the complex principles of traditional Indian (Ayurvedic) and traditional

Chinese medicine.

Herbal medicines form a potentially rich territory worth exploring as a practical way of combating micro-

bial resistance to conventional antibiotics. Herbal medicines have been used as antibiotics for thousands

of years, yet remain effective, suggesting that bacteria have a reduced ability to adapt to a plant-derived

antibacterial regimen.

8

4 HOMEOPATHIC MEDICINE IN HUMANS

Homeopathic treatment is based upon the similarity principle referred to as ‘like cures like’. This

principle advocates that a substance that causes symptoms at a large dose in a healthy person can be used

at lower doses to treat very similar symptoms in a person who is unwell. In practical, clinical terms, a

homeopath aims to match an appropriate homeopathic remedy with the patient’s symptom picture as

closely as possible. In this way, two individuals presenting with tonsillitis, for example, may be prescri-

bed different homeopathic remedies according to their individualised symptoms rather than accord-

ing to the infectious agent. However, in many published trials and tests of the efficacy of homeopathy

the methods used to investigate the treatment being applied infrequently reflect this central homeopathic

principle, thus hampering the ability to demonstrate homeopathy’s effectiveness in a real-world contextd.

Those trials that have reflected the individualised approach collectively reveal that homeopathic medicines

are up to twice as likely as placebos to produce positive effects.e

Homeopathy is considered to be safe with minimal side effects. Adverse events have only occurred when

homeopathic medicines have been improperly self-administered in inappropriate amounts, or when pa-

tients taking homeopathic medicines have not been receiving concomitant conventional medical treatment

where appropriate.51, 52, 53, 54

Homeopathic philosophy holds that homeopathic treatments improve functionality of an individual’s

immune system so that the person can deal with infection efficiently, and restore wellness without lasting

damage or complications.

There is no risk of resistance developing with homeopathic medicines: homeopathic medicinal treat-

ment is aimed at stimulating a homeostatic response in an affected individual, supporting the efficient

endogenous management of infections, e.g. those in the respiratory and urinary tracts without the need for

antimicrobial treatments. In this way, homeopathic treatment focuses on supporting the resistance of the

individual patient and not on the infecting microbe, removing the risk of microbial resistance developing

to homeopathic medicines and leaving current conventional antimicrobial treat-ments to be safeguarded

for essential usage in serious and life-threatening infections.

Upper respiratory tract infections (URTIs) represent one of the most common reasons for antibiotic pre-

scriptions in primary care, with these prescriptions often being unnecessary or inappropriate, because

only approximately one-quarter of URTIs are of bacterial originf. Thus, any novel therapy that can be used

effectively instead of unnecessary antibiotic prescriptions in these acute conditions would help support

the EU strategy to combat antimicrobial resistance.

The balance of moderate and strong evidence is considered positive for the effectiveness of homeopathy

in URTIs, particularly for the following specific infectious conditions that are commonly treated with

antimicrobials: otitis media55, 56, 57, sinusitis58, 59, 60, 61, common cold62, 63, influenza-like syndromes64, 65,

66, 67 and (unspecified) upper respiratory tract infections68, 69, 70 (see Table 2, page 20). Also an HTA re-

port on homeopathy as part of the Swiss Complementary Medicine Evaluation Programme68 concluded

that […] “the trial results showed probable effectiveness of homeopathy for allergies and infectious diseas-

es of the upper respiratory tract. Tolerability of the treatment is very good and is not reduced through combi

d - Mathie RT et al (2012) Method for appraising model validity of randomised controlled trials of homeopathic treatment:

multi-rater concordance study. BMC Medical Research Methodology, 12:49

e - Mathie RT et al (2014) Randomised placebo-controlled trials of individualised homeopathic treatment: systematic review

and meta-analysis. Systematic Reviews, 3:142

f - Lingard H et al (2008). Bacterial superinfection in upper respiratory tract infections estimated by increases in CRP values:

A diagnostic follow-up in primary care. Scandinavian Journal of Primary Health Care, 26(4): 211–215.

9

nation with conventional treatment. Economic advantages are possible due to the fact that homeopathic-

treatment can lessen the need for conventional medication.” That means that homeopathy may be effective

in reducing excessive antibiotic prescribing in primary care.

At the moment there are only two choices in managing acute otitis media and sinusitis: either immed-

iate antibiotic treatment in case it is the uncommon bacterial form of the condition, or delaying antibiotic

therapy for 2-3 days on the basis that it is more likely to be a viral infection (known as ‘watchful waiting’).

The former approach can lead to widespread inappropriate use of antibiotics, whilst the latter may increase

the risk of complications from delayed treatment of a bacterial infection.

In these conditions homeopathy offers an additional choice. In cases where watchful waiting would current-

ly be recommended, homeopathy could be given immediately instead. Any patients who did not respond

to homeopathic treatment by day 3 would be given antibiotics (just as they would with watchful waiting).

As there are virtually no side effects from homeopathic medicines and they do not contribute to anti-micro-

bial resistance, there is no expected negative impact from this proposed additional intervention. However, if

homeopathy proved to be an effective treatment by day 3 of the disease, the potential benefits would include

the reduced use of antibiotics and delivery of prompt treatment.

In conclusion, there is some evidence to support the suggestion that homeopathy could provide an effective

treatment option to support the EU strategy for combating antimicrobial resistance, especially in URTIs

where antibiotics are commonly used.

5 ANTHROPOSOPHIC MEDICINE

Anthroposophic Medicine is an integrative medicine system originated in Europe in the early

1920s, established nowadays in 80 countries worldwide, most significantly in central Europe.g An-

throposophic medi cine is integrated with conventional medicine in hospitals and med ical practices.

It applies me-dicines derived from plants, minerals, and animals; art therapy, eurythmy ther apy, and

rhythmical massage; coun selling; psychotherapy; and specific nursing techniques such as exter-

nal embrocation. Anthroposophic healthcare is provided by medical doctors, therapists, and nurses.

An HTA Reporth and its recent updatei identi fied 265 clinical studies on the effi cacy and effective-

ness of anthropo sophic medicine.

Over decades, anthroposophic doctors practising within the primary health care sector have accumulated a

large expertise in the treatment of bacterial infections using AM remedies alone or, if needed, in combina-

tion with antibiotics. The International Integrative Primary Care Outcomes Study (IIPCOS) on anthropo-

sophic medicine was conducted in four European countries and the United States and compared primary

care patients who were treated by anthroposophic or conventional physicians for acute respiratory and

ear infections72. [For more details of AM trials see Table 3, page 23]. Compared to conven tional therapy,

anthroposophic treatment was associat ed with much lower use of antibiotics and antipyretics as well as

quicker recovery, fewer adverse reactions, and greater therapy satisfaction. These differences remained

after adjustment for country, age, gender, and four markers of baseline severity.

g - Kienle GS, Albonico HU et al. (2013): Anthroposophic Medicine: An Integrative Medical System Originating in Europe.

Global Advances in Health and Medicine 2,6: 20-31

h - Kienle G, Kiene H, Albonico HU (2006) Anthroposophic Medicine. Effectiveness, utility, costs, safety.

Schattauer Verlag, Stuttgart-New York

10

Improvement within 24 hours occurred in 30.9% (221/715) of patients treated by AM doctors and 16.6%

(50/301) of patients treated by conventional doctors. Antibiotics were used in 5,5% of patients in the an-

throposophic doctors group compared to 33,6% in the conventional group. Day 7 complete recovery or

major improvement was reported by 77.1% (AM doctors) vs. 66.1% of patients (conventional doctors),

respectively. Adverse drug reactions were reported in 2.7% patients treated by AM doctors compared to

6.0% within the other group. The safety analysis of the AM medicines used showed that adverse drug reac-

tions were rare (2/715 patients) and mild.

In another multicentre prospective observational study in AM primary care centres in Germany74, 12,081

patients with 19,050 acute upper airway infections occurring during one year of observation were en-

rolled. The infections included most often common cold (63.3%) and acute tonsillitis (12.9%). 73.7% of

patients were children. In 63% of all cases, treatment was purely anthroposophic. In only 6.3% antibiot-

ics were used. Within the group of the 8,900 children with 14,945 respiratory tract infections, antibiotic

prescriptions occurred in only 5.8%. The prescription rate of antibiotics was much lower than the mean

in Germany.

Antibiotic and antipyretic use in early childhood are known today as putative risk factors for the develop-

ment of allergic and autoimmune diseases like asthma, atopic eczema and chronic inflammatory bowel

disease. Thus, a reduced prescription rate of antibiotics and antipyretics is of use not only to reduce AMR

but to increase health performance in children, which could be demonstrated in a well-controlled paedi-

atric epidemiological study.j

A recent study in an anthroposophic hospital73 demonstrated that 16/18 patients with community-ac-

quired pneumonia were successfully treated with anthroposophic medicine only and 2/18 needed ad-

ditional antibiotic therapy (both of risk class IV). Thus, it was shown that even severe infectious diseases

can be cured by means of AM lowering the need for antibiotics significantly.

A recent surveillance on multi-resistant bacteria at the Paracelsus hospital in Bad Liebenzell, Germany,

executed by the Department of Environmental Health Sciences of the Freiburg University revealed that the

percentages of most multi-resistant bacteria in the anthropososphic medicine hospital were much lower

than in the average conventional hospital. Patients mostly have CAM family doctors in their primary care

prescribing antibiotic less often and they received fewer antibiotics during their hospital stay. The data

showed frequencies for Vancomycin-resistant Enterococci of 0.4% (Paracelsus-Hospital) vs. 12.6% (group

of comparable German hospitals of same size and patient structure), imipenem-resistant Pseudomonas

aeruginosa 7.7% vs. 16.8% and multi-resistant gram-negative bacilli (ESBL) 1,2% vs. 10.4% (the percent-

ages of MRSA in anthropososphic medicine hospital vs. conventional hospitals were almost equal: 19%

vs. 21.3%). This can be regarded as proof of principle: overall low prescription rates of antibiotics by fam-

ily doctors and during hospital stays will lead to a significantly reduced prevalence of AMR in hospitals.

i - Kienle GS et al (2011) Klinische Forschung zur Anthroposophischen Medizin - Update eines Health Technology Assessment-Berichts

und Status Quo [Clinical research on anthroposophic medicine: update of a health technology assessment report and status quo].

Forschende Komplementärmedizin, 18(5):269-282of a health technology assessment report and status quo]. Forschende Komple-

mentär medizin, 18(5):269-282

j - Alm JS, Swartz J et al 1999: Atopy in children of families with an anthroposophic lifestyle. Lancet, 353(9163):1485-1488

11

6 ANTIBIOTICS IN THE FARMING INDUSTRY

It is estimated that more than half of the worldwide production of antibiotics is used by the farming

industryk. Animals are routinely put on a course of antibiotics to treat common bacterial infections and it is

now common practice to treat the whole herd prophylactically (metaphylaxis) to stop the infection spread-

ing. In addition, low, sub-therapeutic doses of antibiotics may be given to animals en masse over periods

of weeks when they are considered to be at risk of infection. Although the practice of using low doses of

antibiotics to promote growth in animals is banned in the EU, in practice growth-promoting effects are

achieved through the low doses administered as chemoprophylaxis, thereby blurring the boundaries

between the two uses.

This extensive usage of veterinary antibiotics necessitates the development of sustainable alternatives.

The basis for sustainable animal husbandry lies with a goal-oriented and responsible breeding policy,

appropriate nutrition and housing and professional care with an eye for the individual animal. Health

and wellbeing are intrinsically connected. Measures that improve animal welfare will also have a positive

influence on health and productivity.

Natural feed components and herbal and homeopathic medicinal products can help sustain animal healthl.

Using these products can diminish the number of disease outbreaks on a farm and can help to restrict the

use of antibiotics to a limited number of severely diseased animals. The greatest added value of the use of

natural products is disease and prevention of disease.

7 RECENT POLICY OF THE EUROPEAN COMMISSION IN ORGANIC FARMING

In June 2007 the European Council of Agricultural Ministers agreed on a new Council Regulationm on

organic production and labelling of organic products. This Council Regulation contains defines goals,

principles and general rules for organic production.

The goal of this legal framework was to set a new course for the continued development of organic farm-

ing. Sustainable cultivation systems and a variety of high-quality products are the aim. In this process,

even greater emphasis is placed on environmental protection, biodiversity and high standards of animal

protection. In addition, the legislation aims at ensuring consumer confidence and protecting consumers’

interests.

The European Commission funded ANIPLANn ran from 2007 to 2010 and was aimed to minimise medi-

cine use in organic dairy herds through active and well-planned animal health and welfare promotion and

disease prevention. The process having been implemented on the farms appeared to be a feasible approach

to improve udder health and minimise use of antibiotics without impairment of productivity.

k - Urgent action necessary to safeguard drug treatments, WHO (2011) at

http://www.who.int/mediacentre/news/releases/2011/whd_20110406/en/

l - Groot M,Kleijer-Ligtenberg G, van Asseldonk T, Hansma H (2011) Natural Dairy Cow Health - A guide to keeping your herd healthy

with herbs and other natural products. RIKILT – Institute for Food Safety, Wageningen University and Research Centre;

Institute for Ethnobotany and Zoopharmacognosy (IEZ)

m - Council Regulation (EC) No 834/2007 of 28 June 2007 on organic production and labelling of organic products and repealing

Regulation (EEC) No 2092/91

n - http://www.coreorganic.org/research/projects/aniplan/ANIPLAN_final_report_dec2011.pdf

12

A more recent project, funded by the European Commission under the 7th Research Framework Pro-

gramme, is the IMPRO project – Impact matrix analysis and cost-benefit calculations to improve man-

agement practices regarding health status in organic dairy farming.o This project aims to substantially

overcome weak points in current health management strategies on organic dairy farms and to increase

the implementation of evidence-based measures and to improve practice of health management. It

includes, among other things, (1) the development of a pro-active monitoring protocol aiming for im-

proved effectiveness of preventive and treatment strategies and for a reduction in the use of allopathic

drugs, and (2) the assessment of the manageability of alternative treatments (CAM) according to the

state-of-the-art. It runs until 30 September 2016.

8 HERBAL MEDICINE IN ANIMAL HUSBANDRY

After the ban of antibiotic growth promoters in the European Union many alternative substances

have been investigated for their potential to replace them. An interesting project was initiated in 2006 by

the Dutch Ministry of Agriculture, Nature and Food Quality. The project Development of phytotherapy as a tool

for reducing and/or prevention of diseases in farm animals was carried out by the Institute of Food Safety (RIKILT)

in cooperation with the Universities of Wageningen and Utrecht, the Institute for Ethnobotany and Zoo-

pharmacognosy among others. The goal of the project was to increase the number of available herbal

medicines for organic farmers, but also regular animal husbandry is interested in products that may reduce

the need for antibiotics.

The project showed that there are many herbal products (compounds of several herbs) available that can

be primarily recommended for the promotion of health, both in organic and regular animal husbandry.

Herbal products are mainly used for prevention, particularly in periods in which animals are more vulner-

able to diseases, for example, in case of changing diet, housing or environment. Almost all herbal products

selected for this project showed that the quality could be substantiated and the declared composition could

be confirmed. This shows that reliable quality products are put on the market. In a number of these herbal

products, the claimed effect has been made plausible by laboratory tests and / or animal studies.

Because registration as veterinary medicine is expensive and often not feasible due to the complex nature of

the products, most of these herbal products are sold as supplementary feed or feed additive. Even though

they are not registered as veterinary medicinal products it is advisable to determine the effects of these

herbal products on animal health in an objective manner, making it possible for farmers to rationally ap-

ply these products to their animals and for veterinarians to take account of these products when treating

the animals.

During this project some animal experiments have been performed relating to current health problems

in organic farming. They included animal experiments in proven animal study models where animals fed

with herbal products were compared with untreated control animals. In addition field experiments were

performed both on organic and conventional farms. Experiments were performed with organic layer hens,

grower pigs and dairy cows.

o - http://cordis.europa.eu/project/rcn/104247_en.html

http://www.dev.impro-dairy.eu/index.php/en/

13

The project produced two databases, one on products and one on background literature, which can be ac-

cessed at the website (www.fyto-v.nl). The product database includes 142 herbal products, broken down

by sectors: 86 in cattle, 74 in pigs, 54 in poultry and 41 in small ruminants (a large number of products is

used in several animal species). The literature database covering each single herb has about 500 entriesp.

Currently, veterinary and animal herbalists throughout the world use herbs from several systems of medi-

cine, including Ayurvedic medicine, Western herbal medicine, Traditional Chinese Medicine as well as

Kampo (traditional Japanese medicine). A veterinarian need not adopt any or all of the principles and

practices of these systems of medicine to benefit from its use.

In India a considerable amount of literature on veterinary herbal drug research, clinical trials, pharmacol-

ogy, and basic research has been generated with a view to scientifically systematising the ethnoveterinary

medical practices and folklore claims on herbal treatments. Research efforts by the National Laboratories

and Veterinary, Medical, Pharmacy, and Science Colleges in India have established detailed data regarding

herbs-their effects, effectiveness and safety. The most investigated Ayurvedic herbs and the most commonly

used Ayurvedic herbs in veterinary practice are listed in Wynn & Fougere’s textbook of Veterinary Herbal

Medicineq.

Also phytogenic feed additives or phytobiotics are a promising alternative. These are plant-derived prod-

ucts (extracts or essential oils) added to feed in order to improve performance. They comprise of a very

wide range of substances with respect to biological origin, formulation, chemical description and purity.

They act mainly in the direction of improving gut health, immune system and well-being. A great number

of in vitro and in vivo studies have confirmed a wide range of activities of phytobiotics in animal nutri-

tion like stimulation of feed intake, antimicrobial, coccidiostatic, anthelmintic and immunostimulatingr

action.

Phytobiotics produce their beneficial effects in several wayss: (1) stimulation of feed intake and digestive

secretions (e.g. Sanguinaria canadensis, garlic, horseradish, turmeric), (2) antimicrobial and coccidiostatic

activity (e.g. oregano, cloves, cinnamon) (3) stimulation or moderation of the immune system (e.g. Astra-

galus membranaceus), and (4) antioxidant activity (e.g. rosemary).

9 HOMEOPATHIC MEDICINE IN ANIMAL HUSBANDRY

Homeopathic medicine or homeopathy has traditionally been used for the treatment of animals as

well as humans. In farming it is used for pigs, chickens, turkeys, sheep, and cattle. The most common

diseases treated include diarrhoea, pneumonia, infertility, mastitis, and birthing problems.

Mastitis is an economically important disease of dairy animals throughout world, due to its long-term ef-

fects on milk yields. Huge economic losses are also incurred due to unmarketable milk or milk products

contaminated with antibiotic residues. Conventional treatment depends on the use of antibiotics, which

are not only costly but residues in milk and meat pose human health risks. Indiscriminate use of antibiotic

results in the emergence of resistant bacterial strains causing an increase in treatment failures.

p - http://www.fyto-v.nl/pub_data/table_summary.php?table=literatuur

q - Wynn SG & Fougere B (2006) Veterinary Herbal Medicine, Mosby Elsevier, USA

r - Jacela JY, DeRouchey JM, Tokach MD, et al (2010). Feed additives for swine: Fact sheets – prebiotics and probiotics, and phytogenics.

J Swine Health Prod., 18(3):132–136.

s - Vidanarachchi JK et al (2005). Phytobiotics: alternatives to antibiotic growth promoters in monogastric animal feeds,

Recent Advances in Animal Nutrition in Australia, 15, 131-144

14

Diarrhoea became a disease with significant economic impact in the production of swine due to the systems

of intensive farming adopted. Enteritis can appear in three different stages: neonatal diarrhoea, appearing

during the first days of life; piglet diarrhoea, when it appears from the first week of life to weaning; and

diarrhoea after weaning. Generally, 50-60% of deaths during the suckling stage happen during the first

week of life mainly due to crushing by the sow or neonatal diarrhoea. Neonatal diarrhoea, mostly caused

by Escherichia coli, is the disease with highest impact in production of swine. If left untreated, it leads to

weight loss and, not uncommonly, to death of the piglet, resulting in significant financial losses to the

farmer. Conventional treatments of E. coli diarrhoea is administration of antibiotics to affected piglets,

or preventive vaccination of the sows. A recent study involving the use of homeopathy in the treatment of

E. coli diarrhoea in neonatal piglets showed promising results.81

Antimicrobial use in animals contributes less to the rising problem of resistance and it is obvious that any

non-essential usage of antimicrobials in animals should be curtailed: homeopathy may therefore offer an

appropriate alternative. Homeopathy is emerging as an alternative therapy in veterinary medicine for its

ability to prevent recurrence of diseases without leaving residues in animal products. Homeopathy depends

on the totality of physical and psychological symptoms of the diseased animals and aiming to augment

the body’s immune defences, supporting these rather than treating, inhibiting, or suppressing symptoms.

Homeopathy can be effective in both bacterial and viral diseases. In addition, epidemic diseases in animals

can be addressed with homeopathy, both in a preventive as well as a curative way. With one remedy often a

whole epidemic within a herd can be treated.

Both mastitis in cattle76, 77, 78, 79, 80 and Escherichia coli diarrhoea in swine81, 82 have been identified as clini-

cally relevant issues for which homeopathy could be efficacious and some research has been conducted to

begin evaluating these approaches (see Table 4, page 24).

The most recent trial on Escherichia coli diarrhoea81 is a very good example of how a trial would be relatively

easy and inexpensive to carry out, yet in return for this small investment, the potential rewards could be

significant. It was a robust observer-blind, randomised placebo-controlled trial (triple-blinded, i.e. as to

administration, scoring, and analysis) carried out by researchers at the University of Wageningen in the

Netherlands. It explored the use of a homeopathic medicine derived from Escherichia coli bacteria (Coli 30K)

instead of antibiotics at the prevention of E. Coli diarrhoea in piglets. 52 sows were randomly allocated into

either the homeopathy group or the placebo group. The sows gave birth to 525 piglets that were scored for

occurrence and duration of diarrhoea. The results clearly showed an effect of the homeopathic medicine

with only 3.8% of the homeopathy group suffering from diarrhoea compared to 23.8% in the control group

(p< 0.0001).

This study and others80 indicates that potential benefits of the use of homeopathy in the treatment of

neonatal diarrhoea in piglets is considerable; furthermore it does not carry the risk of AMR. EUROCAM

recommends that a replication of this study be conducted. Given the size of the pig industry, a large-scale

multi-centred approach would allow firm conclusions to be reached as to whether this form of homeo-

pathic treatment is efficacious for prevention of E. coli diarrhoea in piglets in the EU and could therefore

significantly replace the use of antibiotics for this purpose.

We believe that the evidence mentioned here indicates an area of novel antimicrobial treatment options

in animal care that deserve further investment and investigation with adequately sized and appropriately

designed trials.

15

10 CONCLUDING REMARKS AND SUGGESTIONS

EUROCAM supports and encourages integrated and fully informed healthcare choices for patients

and recognises that conventional antimicrobial treatment, when appropriately prescribed, plays a vital

role in managing public health. However, the severity of the threat posed by AMR to global health means

that all potential measures, particularly novel solutions, must be explored as a matter of urgency.

EUROCAM therefore recommends that the potential of CAM in reducing the problem of AMR is given se-

rious consideration and that further research is carried out in this area to determine in which conditions,

both in human and veterinary healthcare, specific CAM modalities are particularly effective. Compared

with other avenues of such as the identification and development of new antibiotics, such trials would be

relatively easy and inexpensive to carry out, yet in return for this small investment, the potential rewards

could be highly significant clinically.

To date, there has been a huge disparity between public funding for conventional drug research and that

for CAM research. Whilst CAM may improve health, reduce disease, reduce health costs and help reduce

the problem of antimicrobial resistance, the CAM sector alone cannot be expected to fund the research

to investigate these possibilities. The CAM industry is small and there are no major financial and/or

industrial interests driving research efforts in this field. Like mainstream medical research, there is a

social responsibility for government to fund such research. As for conventional medicine there should

be industry-independent funded research.

Complementary and Alternative Medicine can support the EU strategy to conserve and steward the

effectiveness of existing antimicrobial treatments and offer an avenue for the development of novel future

therapies. It is time for serious consideration and investment to be given to it.

16

17

Tab

les

TA

BL

E 1

: H

ER

BS

TO

HE

LP

CO

MB

AT

GR

OW

ING

AN

TIB

IOT

IC R

ES

IST

AN

CE

(R

AN

DO

MIS

ED

CO

NT

RO

LL

ED

TR

IAL

S O

NL

Y)

ST

UD

Y D

ES

IGN

PU

BLI

CA

TIO

N D

ET

AIL

SM

AIN

FIN

DIN

GS

PO

SS

IBLE

ME

CH

AN

ISM

SS

TR

EN

GT

H

OF

EV

IDE

NC

E

An

evid

ence

-bas

ed s

yste

mat

ic r

evie

w

of u

mck

aloa

bo (P

elar

goni

um si

doid

es)

by th

e U

S N

atur

al S

tand

ard

Res

earc

h C

olla

bora

tion

.

Ulb

rich

t C e

t al.

(201

0) A

n ev

iden

ce-b

ased

sy

stem

atic

rev

iew

of u

mck

aloa

bo (P

elar

goni

um

sido

ides

) by

the

Nat

ural

Sta

ndar

d R

esea

rch

Col

labo

rati

on.

Jour

nal o

f Die

tary

Sup

plem

ents

, 7(

3):2

83-3

02.38

Thi

s co

mpr

ehen

sive

sys

tem

atic

rev

iew

co

nclu

ded

that

ther

e w

as s

tron

g sc

ient

ific

evid

ence

(Gra

de A

) - in

clud

ing

4 go

od

qual

ity

RC

Ts in

volv

ing

933

part

icip

ants

- t

o su

ppor

t the

use

of p

elar

goni

um fo

r ac

ute

bron

chit

is a

nd g

ood

scie

ntifi

c ev

iden

ce (G

rade

B) f

or th

e it

s us

e in

acu

te

phar

yngi

tis

and

the

com

mon

col

d. N

o se

riou

s to

xic

effe

cts

have

bee

n ob

serv

ed in

an

y tr

ial r

elat

ing

to p

elar

goni

um.

Pela

rgon

ium

has

exh

ibit

ed a

m

arke

d an

tiba

cter

ial a

ctio

n ag

ains

t a w

ide

rang

e of

pa

thog

enic

bac

teri

a.

Stro

ng

Effi

cacy

and

saf

ety

of a

com

bina

tion

he

rbal

med

icin

al p

rodu

ct c

onta

inin

g na

stur

tium

(Tro

paeo

li m

ajor

is h

erba

) an

d H

orse

radi

sh (A

rmor

acia

rust

ican

a)fo

r th

e pr

ophy

lact

ic tr

eatm

ent o

f pat

ient

s w

ith

resp

irat

ory

trac

t dis

ease

s: a

ran

dom

ised

, pr

ospe

ctiv

e, d

oubl

e-bl

ind,

pla

cebo

-co

ntro

lled

phas

e II

I tri

al.

Fint

elm

ann

V e

t al.

(201

2). E

ffica

cy a

nd s

afet

y of

a c

ombi

nati

on h

erba

l med

icin

al p

rodu

ct

cont

aini

ng n

astu

rtiu

m (T

ropa

eoli

maj

oris

he

rba)

and

Hor

sera

dish

(Arm

orac

ia r

usti

cana

) fo

r th

e pr

ophy

lact

ic tr

eatm

ent o

f pat

ient

s w

ith

resp

irat

ory

trac

t dis

ease

s: a

ran

dom

ised

, pr

ospe

ctiv

e, d

oubl

e-bl

ind,

pla

cebo

-con

trol

led

phas

e II

I tri

al. C

urre

nt M

edic

al R

esea

rch

Opi

nion

, 28

(11)

:179

9-18

07.39

351

part

icip

ants

wer

e ra

ndom

ly a

lloca

ted

to e

ithe

r ac

tive

trea

tmen

t (G

roup

1),

a

low

er d

ose

of a

ctiv

e he

rbs

+ p

lace

bo

(Gro

up 2

), o

r ju

st p

lace

bo (G

roup

3).

The

m

axim

um d

urat

ion

of tr

eatm

ent w

as 8

4 da

ys.

In th

e in

tent

ion

to tr

eat (

ITT

) pop

ulat

ion

excl

udin

g ea

rly

infe

ctio

ns (n

= 3

44) t

he

infe

ctio

n ra

tes

wer

e 13

.3%

for

Gro

up 1

, 18

.4%

for

Gro

up 2

and

25.

6% fo

r pl

aceb

o G

roup

3. T

he s

tati

stic

al tr

end

test

sho

wed

si

gnifi

cant

res

ults

(p =

0.0

171)

. The

he

rbal

com

bina

tion

app

ears

to o

ffer

a

prop

hyla

ctic

adv

anta

ge w

hich

cou

ld h

elp

redu

ce a

ntib

ioti

c pr

escr

ipti

on.

The

se h

erbs

con

tain

sev

eral

is

othi

ocya

nate

s w

hich

hav

e a

mar

ked

in v

itro

bro

ad s

pect

rum

an

ti-b

acte

rial

act

ion.

40

Mod

erat

e

A d

oubl

e bl

ind

rand

omis

ed c

ontr

ol tr

ial

whe

re 1

07 p

arti

cipa

nts

wer

e ra

ndom

ised

to

rec

eive

eit

her

licor

ice

root

(Gly

cyrr

hiza

gl

abra

) - t

rade

nam

e gu

tgar

d - o

r pl

aceb

o fo

r 60

day

s

Pura

m e

t al.

(201

3) E

ffec

t of G

utG

ard

in

the

Man

agem

ent o

f Hel

icob

acte

r py

lori

: A

Ran

dom

ized

Dou

ble

Blin

d Pl

aceb

o C

ontr

olle

d St

udy,

Evi

denc

e-Ba

sed

Com

plem

enta

ry a

nd

Alte

rnat

ive M

edic

ine,

Art

icle

ID 2

6380

5. 41

The

res

ults

sho

wed

that

56%

(n=

28) w

ere

H.p

ylor

i neg

ativ

e co

mpa

red

to 4

% (n

=2)

in

the

plac

ebo

grou

p. I

n ot

her

wor

k by

th

e sa

me

team

, the

her

b ex

trac

t red

uced

sy

mpt

oms

of d

yspe

psia

and

ther

e w

ere

no

adve

rse

even

ts r

epor

ted.

Glyc

yrrh

iza

glab

ra s

how

ed

anti

mic

robi

al a

ctiv

ity

in v

itro

an

d an

ti-a

dhes

ive

prop

erti

es

agai

nst H

-pyl

ori.42

Mod

erat

e

18

A r

ando

mis

ed, d

oubl

e-bl

ind,

pla

cebo

-co

ntro

lled

tria

l of a

her

bal m

edic

inal

pr

oduc

t Ang

ocin

Ant

i-In

fekt

N

cont

aini

ng n

astu

rtiu

m (T

ropa

eoli

maj

oris

he

rba)

and

hor

sera

dish

(Arm

orac

iae

rust

ican

a) fo

r th

e pr

ophy

lact

ic tr

eatm

ent o

f pa

tien

ts w

ith

chro

nica

lly r

ecur

rent

low

er

urin

ary

trac

t inf

ecti

ons

(RU

TIs

).

Alb

rech

t U e

t al.

(200

7).

A r

ando

mis

ed,

doub

le-b

lind,

pla

cebo

-con

trol

led

tria

l of

a he

rbal

med

icin

al p

rodu

ct c

onta

inin

g Tr

opae

oli m

ajor

is h

erba

(Nas

turt

ium

) and

A

rmor

acia

e ru

stic

anae

rad

ix (H

orse

radi

sh)

for

the

prop

hyla

ctic

trea

tmen

t of p

atie

nts

wit

h ch

roni

cally

rec

urre

nt lo

wer

uri

nary

trac

t in

fect

ions

. Cu

rren

t Med

ical

Res

earc

h O

pini

on,

23(1

0):2

415-

2422

. 43

129

pati

ents

wit

h R

UT

Is w

ere

rand

omis

ed

to a

ctiv

e he

rbal

or

plac

ebo

trea

tmen

t for

90

day

s. T

he p

rim

ary

outc

ome

was

the

num

ber

of la

bora

tory

con

firm

ed u

rina

ry

trac

t inf

ecti

ons.

The

per

pro

toco

l mea

n nu

mbe

r of

rec

urre

nt U

TIs

in th

e st

udy

peri

od w

as 0

.43

vers

us 0

.77

for

the

plac

ebo

grou

p. T

his

resu

lt is

sta

tist

ical

ly

sign

ifica

nt (p

= 0

.035

). A

tota

l of 3

6 pa

tien

ts in

the

test

gro

up a

nd 3

7 pa

tien

ts

in th

e pl

aceb

o gr

oup

repo

rted

adv

erse

ev

ents

. Tw

o se

riou

s ad

vers

e ev

ents

wer

e re

port

ed in

the

plac

ebo

grou

p an

d on

e se

riou

s ad

vers

e ev

ent i

n th

e tr

eatm

ent

grou

p (n

ot a

ssoc

iate

d w

ith

the

stud

y m

edic

atio

n).

Thi

s he

rbal

pro

duct

app

ears

to b

e ef

fect

ive

and

safe

as

a pr

ophy

laxi

s fo

r R

UT

Is.

Mus

tard

oils

(inc

ludi

ng

isot

hioc

yana

tes)

foun

d in

thes

e tw

o he

rbs

have

bee

n sh

own

to h

ave

a br

oad

spec

trum

an

tiba

cter

ial a

ctio

n.44

Prel

imin

ary

(Thi

s tr

ial n

eeds

to b

e re

peat

ed b

y in

depe

nden

t re

sear

cher

s us

ing

an

inte

ntio

n to

trea

t ana

lysi

s.)

A r

ando

mis

ed c

ontr

ol tr

ial o

f a

com

plex

Chi

nese

her

bal m

edic

ine

(San

Li

ng Ji

e D

u Ta

ng) i

n th

e tr

eatm

ent o

f w

omen

wit

h re

curr

ent l

ower

uri

nary

tr

act i

nfec

tion

s (R

UT

Is)

Hua

ng M

J. (2

007)

. A r

ando

mis

ed c

ontr

ol

tria

l of a

com

plex

Chi

nese

her

bal m

edic

ine

(San

Lin

g Ji

e D

u Ta

ng) i

n th

e tr

eatm

ent

of w

omen

wit

h re

curr

ent l

ower

uri

nary

tr

act i

nfec

tion

s (R

UT

Is),

Hub

ei Jo

urna

l of

Trad

ition

al C

hine

se M

edic

ine;

29:3

8-39

.45

300

wom

en w

ere

rand

omis

ed in

a 2

:1

rati

o to

the

Chi

nese

her

bal r

emed

y or

an

anti

biot

ic. T

reat

men

t was

adm

inis

tere

d fo

r 7

days

wit

h a

6 m

onth

follo

w u

p.

79.5

% o

f the

her

bal g

roup

rep

orte

d no

infe

ctio

n in

the

follo

w u

p pe

riod

co

mpa

red

wit

h 49

% in

the

anti

biot

ic

grou

p. T

his

was

sta

tist

ical

ly s

igni

fica

nt

(p<

0.05

).

Seve

ral o

f the

incl

uded

he

rbs,

suc

h as

tree

peo

ny

bark

(Pae

onia

suffr

otic

osa)

, ha

ve b

een

show

n to

hav

e a

broa

d sp

ectr

um a

ntib

acte

rial

ac

tion

.46

Prel

imin

ary

(Due

to a

lack

of d

etai

l re

lati

ng to

the

tria

l m

etho

dolo

gy.)

A C

ochr

ane

syst

emat

ic r

evie

w o

f C

hine

se h

erbs

for

sore

thro

at.

Hua

ng Y

et a

l. (2

012)

. A

Coc

hran

e sy

stem

atic

rev

iew

of C

hine

se h

erbs

for

sore

th

roat

, Coc

hran

e Dat

abas

e Sys

tem

atic

Rev

iew

. 14

;3:C

D00

4877

.47

12 s

tudi

es in

volv

ing

1954

par

tici

pant

s w

ere

incl

uded

in th

is s

yste

mat

ic r

evie

w.

6/12

stu

dies

wer

e sh

own

to b

e m

ore

effe

ctiv

e th

an th

e co

ntro

l wit

h 3

herb

al

rem

edie

s ap

pear

ing

mor

e ef

fect

ive

than

an

tibi

otic

s. T

he r

emai

ning

6 s

tudi

es

show

ed e

quiv

alen

t eff

ecti

vene

ss to

the

cont

rols

.

Seve

ral o

f the

incl

uded

her

bs

such

as

Japa

nese

Hon

eysu

ckle

(L

onic

era

japo

nica

), ha

ve

been

sho

wn

to h

ave

a br

oad

spec

trum

ant

i-ba

cter

ial

acti

on.48

Prel

imin

ary

(Due

to th

e po

or

met

hodo

logi

cal q

ualit

y of

the

incl

uded

tria

ls.)

Com

para

tive

stu

dy o

f Nig

ella

sativ

a an

d tr

iple

ther

apy

in e

radi

cati

on o

f H

elic

obac

ter p

ylor

i in

pati

ents

wit

h no

n-ul

cer

dysp

epsi

a. 8

8 ad

ults

wit

h dy

spep

tic

sym

ptom

s an

d po

siti

ve

H.p

ylor

i tes

t wer

e ra

ndom

ised

to fo

ur

grou

ps: r

ecei

ving

i) tr

iple

ther

apy

(TT

) com

pris

ing

of c

lari

thro

myc

in,

amox

icill

in, o

mep

razo

le [

n= 2

3], i

i) 1

g

Nig

ella

sativ

a +

40

mg

omep

razo

le (O

M)

[n=

21]

, iii)

2 g

NS

+ O

M [

n= 2

1] o

r iv

) 3

g N

S +

OM

[n=

23]

. M

ain

outc

ome

was

era

dica

tion

of H

.pyl

ori.

Sale

m e

t al.

(201

0). C

ompa

rati

ve s

tudy

of

Nig

ella

sativ

a an

d tr

iple

ther

apy

in e

radi

cati

on

of H

elic

obac

ter

pylo

ri in

pat

ient

s w

ith

non-

ulce

r dy

spep

sia.

Sau

di Jo

urna

l of

Gast

roen

tero

logy

. 16(

3):2

07-2

14.49

H.p

ylor

i era

dica

tion

was

82.

6% in

the

anti

biot

ic tr

iple

ther

apy

grou

p, 4

7.6

wit

h 1g

of N

igel

la sa

tiva,

66.

7% w

ith

2g a

nd 4

7.8%

wit

h 3g

Nig

ella

sativ

a.

Erad

icat

ion

rate

s w

ith

2 g

Nig

ella

sa

tiva

and

anti

biot

ics

wer

e st

atis

tica

lly

sim

ilar.

Nig

ella

sativ

a se

eds

poss

ess

clin

ical

ly u

sefu

l ant

i-H

.pyl

ori a

ctiv

ity,

co

mpa

rabl

e to

ant

ibio

tic

trip

le th

erap

y.

In v

itro

stu

dy s

how

ed th

at

Nig

ella

sativ

a in

hibi

ted

grow

th

in a

ll st

rain

s of

H.p

ylor

i wit

hin

60 m

inut

es o

f exp

osur

e.50

Prel

imin

ary

TA

BL

E 1

: H

ER

BS

TO

HE

LP

CO

MB

AT

GR

OW

ING

AN

TIB

IOT

IC R

ES

IST

AN

CE

(R

AN

DO

MIS

ED

CO

NT

RO

LL

ED

TR

IAL

S O

NL

Y)

ST

UD

Y D

ES

IGN

PU

BLI

CA

TIO

N D

ET

AIL

SM

AIN

FIN

DIN

GS

PO

SS

IBLE

ME

CH

AN

ISM

SS

TR

EN

GT

H

OF

EV

IDE

NC

E

An

evid

ence

-bas

ed s

yste

mat

ic r

evie

w

of u

mck

aloa

bo (P

elar

goni

um si

doid

es)

by th

e U

S N

atur

al S

tand

ard

Res

earc

h C

olla

bora

tion

.

Ulb

rich

t C e

t al.

(201

0) A

n ev

iden

ce-b

ased

sy

stem

atic

rev

iew

of u

mck

aloa

bo (P

elar

goni

um

sido

ides

) by

the

Nat

ural

Sta

ndar

d R

esea

rch

Col

labo

rati

on.

Jour

nal o

f Die

tary

Sup

plem

ents

, 7(

3):2

83-3

02.38

Thi

s co

mpr

ehen

sive

sys

tem

atic

rev

iew

co

nclu

ded

that

ther

e w

as s

tron

g sc

ient

ific

evid

ence

(Gra

de A

) - in

clud

ing

4 go

od

qual

ity

RC

Ts in

volv

ing

933

part

icip

ants

- t

o su

ppor

t the

use

of p

elar

goni

um fo

r ac

ute

bron

chit

is a

nd g

ood

scie

ntifi

c ev

iden

ce (G

rade

B) f

or th

e it

s us

e in

acu

te

phar

yngi

tis

and

the

com

mon

col

d. N

o se

riou

s to

xic

effe

cts

have

bee

n ob

serv

ed in

an

y tr

ial r

elat

ing

to p

elar

goni

um.

Pela

rgon

ium

has

exh

ibit

ed a

m

arke

d an

tiba

cter

ial a

ctio

n ag

ains

t a w

ide

rang

e of

pa

thog

enic

bac

teri

a.

Stro

ng

Effi

cacy

and

saf

ety

of a

com

bina

tion

he

rbal

med

icin

al p

rodu

ct c

onta

inin

g na

stur

tium

(Tro

paeo

li m

ajor

is h

erba

) an

d H

orse

radi

sh (A

rmor

acia

rust

ican

a)fo

r th

e pr

ophy

lact

ic tr

eatm

ent o

f pat

ient

s w

ith

resp

irat

ory

trac

t dis

ease

s: a

ran

dom

ised

, pr

ospe

ctiv

e, d

oubl

e-bl

ind,

pla

cebo

-co

ntro

lled

phas

e II

I tri

al.

Fint

elm

ann

V e

t al.

(201

2). E

ffica

cy a

nd s

afet

y of

a c

ombi

nati

on h

erba

l med

icin

al p

rodu

ct

cont

aini

ng n

astu

rtiu

m (T

ropa

eoli

maj

oris

he

rba)

and

Hor

sera

dish

(Arm

orac

ia r

usti

cana

) fo

r th

e pr

ophy

lact

ic tr

eatm

ent o

f pat

ient

s w

ith

resp

irat

ory

trac

t dis

ease

s: a

ran

dom

ised

, pr

ospe

ctiv

e, d

oubl

e-bl

ind,

pla

cebo

-con

trol

led

phas

e II

I tri

al. C

urre

nt M

edic

al R

esea

rch

Opi

nion

, 28

(11)

:179

9-18

07.39

351

part

icip

ants

wer

e ra

ndom

ly a

lloca

ted

to e

ithe

r ac

tive

trea

tmen

t (G

roup

1),

a

low

er d

ose

of a

ctiv

e he

rbs

+ p

lace

bo

(Gro

up 2

), o

r ju

st p

lace

bo (G

roup

3).

The

m

axim

um d

urat

ion

of tr

eatm

ent w

as 8

4 da

ys.

In th

e in

tent

ion

to tr

eat (

ITT

) pop

ulat

ion

excl

udin

g ea

rly

infe

ctio

ns (n

= 3

44) t

he

infe

ctio

n ra

tes

wer

e 13

.3%

for

Gro

up 1

, 18

.4%

for

Gro

up 2

and

25.

6% fo

r pl

aceb

o G

roup

3. T

he s

tati

stic

al tr

end

test

sho

wed

si

gnifi

cant

res

ults

(p =

0.0

171)

. The

he

rbal

com

bina

tion

app

ears

to o

ffer

a

prop

hyla

ctic

adv

anta

ge w

hich

cou

ld h

elp

redu

ce a

ntib

ioti

c pr

escr

ipti

on.

The

se h

erbs

con

tain

sev

eral

is

othi

ocya

nate

s w

hich

hav

e a

mar

ked

in v

itro

bro

ad s

pect

rum

an

ti-b

acte

rial

act

ion.

40

Mod

erat

e

A d

oubl

e bl

ind

rand

omis

ed c

ontr

ol tr

ial

whe

re 1

07 p

arti

cipa

nts

wer

e ra

ndom

ised

to

rec

eive

eit

her

licor

ice

root

(Gly

cyrr

hiza

gl

abra

) - t

rade

nam

e gu

tgar

d - o

r pl

aceb

o fo

r 60

day

s

Pura

m e

t al.

(201

3) E

ffec

t of G

utG

ard

in

the

Man

agem

ent o

f Hel

icob

acte

r py

lori

: A

Ran

dom

ized

Dou

ble

Blin

d Pl

aceb

o C

ontr

olle

d St

udy,

Evi

denc

e-Ba

sed

Com

plem

enta

ry a

nd

Alte

rnat

ive M

edic

ine,

Art

icle

ID 2

6380

5. 41

The

res

ults

sho

wed

that

56%

(n=

28) w

ere

H.p

ylor

i neg

ativ

e co

mpa

red

to 4

% (n

=2)

in

the

plac

ebo

grou

p. I

n ot

her

wor

k by

th

e sa

me

team

, the

her

b ex

trac

t red

uced

sy

mpt

oms

of d

yspe

psia

and

ther

e w

ere

no

adve

rse

even

ts r

epor

ted.

Glyc

yrrh

iza

glab

ra s

how

ed

anti

mic

robi

al a

ctiv

ity

in v

itro

an

d an

ti-a

dhes

ive

prop

erti

es

agai

nst H

-pyl

ori.42

Mod

erat

e

19

TA

BL

E 2

: H

OM

EO

PA

TH

Y I

N U

PP

ER

AN

D L

OW

ER

RE

SP

IRA

TO

RY

TR

AC

T I

NF

EC

TIO

NS

(R

AN

DO

MIS

ED

CO

NT

RO

LL

ED

TR

IAL

S O

NL

Y)

ST

UD

Y D

ES

IGN

PU

BLI

CA

TIO

N D

ET

AIL

SM

AIN

FIN

DIN

GS

ST

RE

NG

TH

O

F E

VID

EN

CE

A r

ando

miz

ed d

oubl

e-bl

ind

plac

ebo

cont

rol p

ilot

stud

y of

indi

vidu

aliz

ed h

omeo

path

y.Ja

cobs

J, S

prin

ger

DA

, Cro

ther

s D

(200

1). H

omeo

path

ic

trea

tmen

t of a

cute

oti

tis

med

ia in

chi

ldre

n: a

pre

limin

ary

rand

omiz

ed p

lace

bo-c

ontr

olle

d tr

ial.

Pedi

atri

c Inf

ectio

us D

isea

se

Jour

nal,

20:1

77-1

83.

The

re w

ere

few

er tr

eatm

ent f

ailu

res

in th

e gr

oup

rece

ivin

g ho

meo

path

y af

ter

5 da

ys, 2

wee

ks a

nd 6

wee

ks, w

ith

diff

eren

ces

of 1

1.4,

18.

4 an

d 19

.9%

, res

pect

ivel

y, b

ut th

ese

diff

eren

ces

wer

e no

t sta

tist

ical

ly s

igni

fica

nt. D

iary

sco

res

show

ed a

sig

nifi

cant

dec

reas

e in

sym

ptom

s at

24

and

64 h

aft

er

trea

tmen

t in

favo

ur o

f hom

eopa

thy

(P <

0.0

5).

Stro

ng

Chi

ldre

n w

ith

acut

e ot

itis

med

ia w

ere

enro

lled

in

the

stud

y at

the

tim

e of

dia

gnos

is a

nd r

ando

miz

ed

to r

ecei

ve e

ithe

r st

anda

rd th

erap

y al

one

or

stan

dard

ther

apy

plus

a h

omeo

path

ic e

ar d

rop

solu

tion

that

was

to b

e us

ed o

n as

nee

ded

basi

s fo

r up

to 5

day

s.

Tayl

or JA

, Jac

obs

J (20

11).

Hom

eopa

thic

ear

dro

ps a

s an

ad

junc

t to

stan

dard

ther

apy

in c

hild

ren

wit

h ac

ute

otit

is m

edia

. H

omeo

path

y, 1

00(3

):10

9-15

.

A to

tal o

f 119

elig

ible

chi

ldre

n w

ere

enro

lled

in th

e st

udy;

sy

mpt

om d

iari

es w

ere

rece

ived

from

94

(79%

). S

ympt

om

scor

es te

nded

to b

e lo

wer

in th

e gr

oup

of c

hild

ren

rece

ivin

g ea

r dr

ops

than

in th

ose

rece

ivin

g st

anda

rd th

erap

y al

one;

th

ese

diff

eren

ces

wer

e si

gnifi

cant

at t

he s

econ

d an

d th

ird

asse

ssm

ents

(P =

0.0

4 an

d P

= 0

.003

, res

pect

ivel

y). I

n ad

diti

on,

the

rate

of s

ympt

om im

prov

emen

t was

fast

er in

chi

ldre

n in

the

ear

drop

gro

up c

ompa

red

wit

h ch

ildre

n in

sta

ndar

d th

erap

y al

one

grou

p (P

= 0

.002

).

Stro

ng

A r

ando

miz

ed p

lace

bo-c

ontr

olle

d pa

ralle

l gro

up

pilo

t stu

dy o

f hom

eopa

thic

vs

conv

enti

onal

tr

eatm

ent f

or a

cute

oti

tis

med

ia. P

atie

nts

wer

e ra

ndom

ized

by

a co

mpu

ter

gene

rate

d ra

ndom

nu

mbe

r lis

t to

rece

ive

eith

er in

divi

dual

ized

ho

meo

path

ic m

edic

ines

in fi

fty

mill

esim

al (L

M)

pote

ncie

s, o

r co

nven

tion

al tr

eatm

ent i

nclu

ding

an

alge

sics

, ant

ipyr

etic

s an

d an

ti-i

nflam

mat

ory

drug

s. P

atie

nts

who

did

not

impr

ove

wer

e pr

escr

ibed

ant

ibio

tics

at t

he 3

rd d

ay. O

utco

mes

w

ere

asse

ssed

by

the

Acu

te O

titi

s M

edia

-Sev

erit

y of

Sym

ptom

s (A

OM

-SO

S) S

cale

and

Tym

pani

c M

embr

ane

Exam

inat

ion

over

21

days

.

Sinh

a M

N, S

iddi

qui V

A, N

ayak

C, S

ingh

V, D

ixit

R, D

ewan

D,

Mis

hra

A (2

012)

. Ran

dom

ized

con

trol

led

pilo

t stu

dy to

com

pare

ho

meo

path

y an

d co

nven

tion

al th

erap

y in

acu

te o

titi

s m

edia

. H

omeo

path

y, 1

01: 5

-12.

81 p

atie

nts

wer

e in

clud

ed, 8

0 co

mpl

eted

follo

w-u

p: 4

1 fo

r co

nven

tion

al a

nd 4

0 fo

r ho

meo

path

ic tr

eatm

ent.

In th

e co

nven

tion

al g

roup

, all

40 (1

00%

) pat

ient

s w

ere

cure

d, in

the

hom

eopa

thy

grou

p, 3

8 (9

5%) p

atie

nts

wer

e cu

red

whi

le 0

2 (5

%) p

atie

nts

wer

e lo

st to

the

last

two

follo

w-u

p. B

y th

e 3r

d da

y of

trea

tmen

t, 4

pat

ient

s w

ere

cure

d in

Hom

eopa

thy

grou

p bu

t in

conv

enti

onal

gro

up o

nly

one

pati

ent w

as c

ured

. In

the

conv

enti

onal

gro

up a

ntib

ioti

cs w

ere

pres

crib

ed in

39

(97.

5%),

no

ant

ibio

tics

wer

e re

quir

ed in

the

hom

eopa

thy

grou

p. 8

5% o

f pa

tien

ts w

ere

pres

crib

ed s

ix h

omeo

path

ic m

edic

ines

.

Non

e(N

on-

conc

lusi

ve)

A p

rosp

ecti

ve r

ando

miz

ed, d

oubl

e-bl

ind

stud

y in

clud

ing

144

pati

ents

wit

h ac

ute

rhin

osin

usit

is.

The

y re

ceiv

ed e

ithe

r a

hom

eopa

thic

rem

edy

(n=

72) o

r pl

aceb

o (n

=72

). A

t the

con

trol

ex

amin

atio

ns a

fter

7, 1

4 an

d 21

day

s, fi

ve

sinu

siti

s-ty

pica

l sym

ptom

s w

ere

mea

sure

d w

ith

scor

es fr

om 0

(abs

ent)

to 4

(ver

y st

rong

).

Frie

se K

-H, Z

abal

otny

i DI (

2007

) Hom

öopa

thie

bei

aku

ter

Rhi

nosi

nusi

tis.

Ein

e do

ppel

blin

de, p

lace

boko

ntro

llier

te

Stud

ie b

eleg

t die

Wir

ksam

keit

und

Ver

träg

lichk

eit e

ines

ho

möo

path

isch

en K

ombi

nati

ons-

arzn

eim

itte

ls [

Hom

eopa

thy

in a

cute

rhi

nosi

nusi

tis.

A d

oubl

e-bl

ind,

pla

cebo

con

trol

led

stud

y sh

ows

the

effe

ctiv

enes

s an

d to

lera

bilit

y of

a h

omeo

path

ic

com

bina

tion

rem

edy]

. HN

O, 5

5: 2

71-7

.

In th

e ho

meo

path

ic tr

eatm

ent g

roup

, the

ave

rage

sum

sco

re

drop

ped

from

init

ially

12.

1+/-

1.6

to 5

.9+

/-2.

0 po

ints

aft

er 7

da

ys. I

n th

e pl

aceb

o gr

oup

it d

ecre

ased

from

11.

7+/-

1.6

to

11.0

+/-

2.9

poin

ts (p

<0.

0001

). T

he h

omeo

path

ic tr

eatm

ent

resu

lted

in fr

eedo

m fr

om c

ompl

aint

s in

90.

3% o

f the

pat

ient

s an

d im

prov

emen

t in

a fu

rthe

r 8.

3%, w

here

as in

the

plac

ebo

grou

p, th

e co

mpl

aint

s re

mai

ned

unch

ange

d or

bec

ame

wor

se

in 8

8.9%

of t

he p

atie

nts.

Stro

ng

A p

rosp

ecti

ve, r

ando

miz

ed, d

oubl

e-bl

ind,

pl

aceb

o-co

ntro

lled,

pha

se II

I clin

ical

tria

l was

co

nduc

ted

for

a tr

eatm

ent p

erio

d of

22

days

, fo

llow

ed b

y an

eig

ht-w

eek

post

-tre

atm

ent

obse

rvat

iona

l pha

se. 1

13 p

atie

nts

wit

h ra

diog

raph

y-co

nfirm

ed A

MS

part

icip

ated

in th

e tr

ial.

Zabo

lotn

yi D

I, K

neis

KC

, Ric

hard

son

A e

t al (

2007

). E

ffica

cy o

f a

com

plex

hom

eopa

thic

med

icat

ion

(Sin

fron

tal)

in p

atie

nts

wit

h ac

ute

max

illar

y si

nusi

tis:

a p

rosp

ecti

ve, r

ando

miz

ed, d

oubl

e-bl

ind,

pla

cebo

-con

trol

led,

mul

tice

ntre

clin

ical

tria

l. Ex

plor

e (N

Y),

3: 9

8-10

9.

From

day

zer

o to

day

sev

en, S

infr

onta

l cau

sed

a si

gnifi

cant

re

duct

ion

in th

e SS

S to

tal s

core

com

pare

d w

ith

plac

ebo

(5.8

+/-

2.

3 [6

.0]

poin

ts v

s 2.

3 +

/- 1

.8 [

2.0]

poi

nts;

P <

.000

1). O

n da

y 21

, 39

(68.

4%) p

atie

nts

on a

ctiv

e m

edic

atio

n ha

d a

com

plet

e re

mis

sion

of A

MS

sym

ptom

s co

mpa

red

wit

h fi

ve (8

.9%

) pl

aceb

o pa

tien

ts. A

ll se

cond

ary

outc

ome

crit

eria

dis

play

ed

sim

ilar

tren

ds. E

ight

adv

erse

eve

nts

wer

e re

port

ed th

at w

ere

asse

ssed

as

bein

g m

ild o

r m

oder

ate

in in

tens

ity.

No

recu

rren

ce

of A

MS

sym

ptom

s oc

curr

ed b

y th

e en

d of

the

eigh

t-w

eek

post

-tr

eatm

ent o

bser

vati

onal

pha

se.

Stro

ng

20

A r

ando

miz

ed p

lace

bo-c

ontr

olle

d do

uble

-blin

d st

udy

over

a 5

-mon

th p

erio

d in

clud

ing

173

pati

ents

wit

h ch

roni

c si

nusi

tis,

155

of w

hom

wer

e in

clud

ed in

the

fina

l eva

luat

ion

(89.

6%)

Wei

ser

M, C

lase

n B

(199

4). R

ando

mis

iert

e pl

azeb

o-ko

ntro

liert

e D

oppe

lblin

dstu

die

zur

Unt

ersu

chun

g de

r kl

inis

che

Wir

ksam

keit

de

r ho

möo

path

isch

en E

upho

rbiu

m c

ompo

situ

m-N

asen

trop

fen

S be

i chr

onis

cher

Sin

usit

is [

Ran

dom

ised

, pla

cebo

-con

trol

led,

do

uble

-blin

d st

udy

of th

e cl

inic

al e

ffica

cy o

f the

hom

eopa

thic

Eu

phor

bium

com

posi

tum

-S n

asal

spr

ay in

cas

es o

f chr

onic

si

nusi

tis]

. For

sche

nde K

ompl

emen

tärm

ediz

in, 1

:251

-259

.

Stat

isti

cal c

ompa

riso

n of

the

ther

apeu

tic

colle

ctiv

es

dem

onst

rate

s a

sign

ifica

nt s

uper

iori

ty o

f Eup

horb

ium

co

mpo

situ

m S

nas

al s

pray

(5%

sig

nifi

canc

e le

vel,

p=0.

016)

. Im

prov

emen

t was

mos

t evi

dent

wit

hin

the

subj

ecti

ve c

rite

ria

of

resp

irat

ory

obst

ruct

ion,

sen

sati

on o

f pre

ssur

e an

d he

adac

he.

Stro

ng

A r

ando

miz

ed d

oubl

e-bl

ind

cont

rolle

d tr

ial

incl

udin

g 15

2 pa

tien

ts w

ith

sinu

siti

s. T

he e

ffec

t of

one

sing

le h

omeo

path

ic m

edic

ine

and

two

fixe

d co

mbi

nati

ons

of h

omeo

path

ic m

edic

ines

wer

e co

mpa

red

wit

h a

plac

ebo

grou

p.

Wie

sena

uer

M, G

aus

W e

t al (

1989

). W

irks

amke

itsp

rüfu

ng

von

hom

öopa

this

che

Kom

bina

tion

sprä

para

ten

bei S

inus

itis

. Er

gebn

isse

ein

er r

ando

mis

iert

en D

oppe

lblin

dstu

die

unte

r Pr

axis

bedi

ngun

gen

[Effi

cien

cy o

f hom

eopa

thic

pre

para

tion

co

mbi

nati

ons

in s

inus

itis

. Res

ults

of a

ran

dom

ized

dou

ble

blin

d st

udy

wit

h ge

nera

l pra

ctit

ione

rs].

Arz

neim

ittel

For

schu

ng,

39:6

20–6

25.

No

rem

arka

ble

diff

eren

ce in

the

ther

apeu

tic

succ

ess

coul

d be

fo

und

amon

g th

e va

riou

s gr

oups

.N

one

(Non

-co

nclu

sive

)

A r

ando

miz

ed, d

oubl

e-bl

ind,

pla

cebo

-con

trol

led,

6-

day

pilo

t stu

dy in

clud

ing

30 c

hild

ren,

age

6 to

12

yea

rs, w

ith

acut

e vi

ral t

onsi

lliti

s

Con

trol

led

clin

ical

tria

l inc

ludi

ng 5

3 ou

tpat

ient

s su

ffer

ing

from

com

mon

col

d (fl

u) w

ho w

ere

rand

omly

ass

igne

d to

eit

her

a th

erap

y w

ith

acet

ylsa

licyl

ic a

cid

(ASA

) or

the

hom

eopa

thic

dr

ug E

upat

oriu

m p

erfo

liatu

m D

2 in

a c

ontr

olle

d cl

inic

al tr

ial.

Mal

apan

e E

et a

l (20

14).

Effi

cacy

of a

hom

eopa

thic

com

plex

on

acut

e vi

ral t

onsi

lliti

s. Jo

urna

l of A

lter

nati

ve a

nd C

ompl

emen

tary

M

edic

ine,

20(

11):

868-

873.

Gas

sing

er C

A, W

ünst

el G

, Net

ter

P (1

981)

. Klin

isch

e Pr

üfun

g zu

m N

achw

eis

der

ther

apeu

tisc

hen

Wir

ksam

keit

des

ho

möo

path

isch

en A

rzne

imit

tels

Eup

ator

ium

per

folia

tum

D

2 (W

asse

rhan

f com

posi

te) b

ei d

er D

iagn

ose

“Gri

ppal

er

Infe

kt”.

[A

con

trol

led

clin

ical

tria

l for

test

ing

the

effi

cacy

of t

he

hom

eopa

thic

dru

g Eu

pato

rium

per

folia

tum

D2

in th

e tr

eatm

ent

of c

omm

on c

old]

. Arz

neim

ittel

For

schu

ng, 3

1:73

2–73

6.

The

trea

tmen

t gro

up h

ad a

sta

tist

ical

ly s

igni

fica

ntim

prov

emen

t in

the

follo

win

g sy

mpt

oms

com

pare

d w

ith

the

plac

ebo

grou

p: p

ain

asso

ciat

edw

ith

tons

illit

is, p

ain

on s

wal

low

ing,

ery

them

a an

din

flam

mat

ion

of th

e ph

aryn

x, a

nd to

nsil

size

.

The

effi

cacy

of t

he d

rugs

was

ass

esse

d on

day

1, 4

and

10

of th

e in

fect

ion

by s

ympt

om c

heck

list

s an

d ph

ysic

al e

xam

inat

ions

. N

eith

er s

ubje

ctiv

e co

mpl

aint

s no

r bo

dy te

mpe

ratu

re o

r la

bora

tory

find

ings

sho

wed

any

sig

nifi

cant

dif

fere

nces

be

twee

n gr

oups

whi

ch w

as ta

ken

as e

vide

nce

that

bot

h dr

ugs

wer

e eq

ually

eff

ecti

ve.

Mod

erat

e

Mod

erat

e

A r

ando

miz

ed d

oubl

e-bl

ind

clin

ical

stu

dy

incl

udin

g 17

0 ar

my

sold

iers

suf

feri

ng fr

om

com

mon

col

d. T

he te

st w

as c

ondu

cted

on

a m

onoc

entr

ic, r

ando

miz

ed, n

on-s

eque

ntia

l, an

d in

ter-

indi

vidu

al b

asis

, com

pari

ng th

e ef

fect

iven

ess

of a

com

bina

tion

hom

eopa

thic

pr

epar

atio

n (G

ripp

-Hee

l) w

ith

that

of

acet

ylsa

licyl

ic a

cid.

Mai

wal

d V

L, W

einf

urtn

er T

et a

l (19

88).

The

rapi

e de

s gr

ippa

len

Infe

kts

mit

ein

em h

omöo

path

isch

en K

ombi

nati

onsp

räpa

rat i

m

Verg

leic

h zu

Ace

tyls

alyc

ilsäu

re. K

ontr

ollie

rte,

ran

dom

isie

rte

Einf

achb

linds

tudi

e [T

reat

men

t of c

omm

on c

old

wit

h a

com

bina

tion

hom

eopa

thic

pre

para

tion

com

pare

d w

ith

acet

ylsa

licyl

ic a

cid.

A c

ontr

olle

d, r

ando

miz

ed s

ingl

e-bl

ind

stud

y]. A

rzne

imitt

el F

orsc

hung

, 38:

578-

582

On

the

4th

and

10th

trea

tmen

t day

s, n

o si

gnifi

cant

dif

fere

nce

was

det

erm

ined

wit

h re

spec

t to

chan

ges

in c

linic

al fi

ndin

gs,

subj

ecti

vely

ass

esse

d co

mpl

aint

s, o

r le

ngth

of t

ime

the

pati

ents

w

ere

unab

le to

wor

k. T

hus

the

two

prep

arat

ions

pos

sess

co

mpa

rati

ve e

ffec

tive

ness

in th

e tr

eatm

ent o

f the

com

mon

co

ld.

Mod

erat

e

A r

ando

miz

ed d

oubl

e-bl

ind

cont

rolle

d tr

ial

incl

udin

g 12

4 ch

roni

cally

ill r

esid

ents

(73

in th

e ve

rum

gro

up, 5

1 in

the

cont

rol g

roup

). A

ntib

ody

prod

ucti

on w

as d

eter

min

ed in

ser

um s

ampl

es

colle

cted

bef

ore

and

thre

e an

d fo

ur w

eeks

aft

er

trea

tmen

t wit

h G

ripp

-Hee

l. T

he s

ame

proc

edur

es

wer

e ca

rrie

d ou

t in

the

cont

rol g

roup

.

Bry

dak

LB, D

enys

A (1

999)

. The

eva

luat

ion

of h

umor

al r

espo

nse

and

the

clin

ical

eva

luat

ion

of a

ris

k-gr

oup

pati

ents

’ sta

te o

f he

alth

aft

er a

dmin

istr

atio

n of

the

hom

eopa

thic

pre

para

tion

G

ripp

-Hee

l dur

ing

the

infl

uenz

a ep

idem

ic s

easo

n 19

93 to

94.

In

tern

atio

nal R

evie

w o

f Alle

rgol

ogy

and

Clin

ical

Imm

unol

ogy,

5:2

23-

227.

Thr

ee w

eeks

aft

er a

dmin

istr

atio

n of

Gri

pp-H

eel G

eom

etri

c M

ean

Ant

ibod

y T

iter

s fo

r he

mag

glut

inin

s H

1, H

3 an

d H

B

wer

e ab

out 2

tim

es h

ighe

r th

an b

efor

e tr

eatm

ent.

Geo

met

ric

Mea

n T

iter

s fo

r ne

uroa

min

idas

e N

1 w

as 9

.5 ti

mes

hig

her

than

be

fore

dru

g ad

min

istr

atio

n, w

hile

for

neur

amin

idas

e N

2 it

was

15

.4 ti

mes

hig

her

and

for

neur

amin

idas

e N

B it

was

8.0

tim

es

high

er. I

n th

e co

ntro

l gro

up G

MTs

wer

e ne

arly

on

the

sam

e le

vel.

Stro

ng

A r

ando

miz

ed p

lace

bo-c

ontr

olle

d cl

inic

al tr

ial

to a

sses

s th

e ef

fect

iven

ess

of a

hom

eopa

thic

pr

epar

atio

n in

the

trea

tmen

t of i

nflue

nza-

like

synd

rom

es. 2

37 c

ases

in v

erum

gro

up, 2

41 in

pl

aceb

o gr

oup.

Ferl

ey JP

, Zm

irou

D e

t al (

1989

). A

con

trol

led

eval

uati

on o

f a

hom

eopa

thic

pre

para

tion

in th

e tr

eatm

ent o

f infl

uenz

a lik

e sy

ndro

mes

. Bri

tish

Jour

nal o

f Clin

ical

Pha

rmac

olog

y, 2

7:32

9-33

5.

The

pro

port

ion

of c

ases

who

rec

over

ed w

ithi

n 48

hou

rs o

f tr

eatm

ent w

as g

reat

er a

mon

g th

e ac

tive

dru

g gr

oup

than

am

ong

the

plac

ebo

grou

p (1

7.1%

aga

inst

10.

3%, P

= 0

.03)

.

Stro

ng

TA

BL

E 2

: H

OM

EO

PA

TH

Y I

N U

PP

ER

AN

D L

OW

ER

RE

SP

IRA

TO

RY

TR

AC

T I

NF

EC

TIO

NS

(R

AN

DO

MIS

ED

CO

NT

RO

LL

ED

TR

IAL

S O

NL

Y)

ST

UD

Y D

ES

IGN

PU

BLI

CA

TIO

N D

ET

AIL

SM

AIN

FIN

DIN

GS

ST

RE

NG

TH

O

F E

VID

EN

CE

A r

ando

miz

ed d

oubl

e-bl

ind

plac

ebo

cont

rol p

ilot

stud

y of

indi

vidu

aliz

ed h

omeo

path

y.Ja

cobs

J, S

prin

ger

DA

, Cro

ther

s D

(200

1). H

omeo

path

ic

trea

tmen

t of a

cute

oti

tis

med

ia in

chi

ldre

n: a

pre

limin

ary

rand

omiz

ed p

lace

bo-c

ontr

olle

d tr

ial.

Pedi

atri

c Inf

ectio

us D

isea

se

Jour

nal,

20:1

77-1

83.

The

re w

ere

few

er tr

eatm

ent f

ailu

res

in th

e gr

oup

rece

ivin

g ho

meo

path

y af

ter

5 da

ys, 2

wee

ks a

nd 6

wee

ks, w

ith

diff

eren

ces

of 1

1.4,

18.

4 an

d 19

.9%

, res

pect

ivel

y, b

ut th

ese

diff

eren

ces

wer

e no

t sta

tist

ical

ly s

igni

fica

nt. D

iary

sco

res

show

ed a

sig

nifi

cant

dec

reas

e in

sym

ptom

s at

24

and

64 h

aft

er

trea

tmen

t in

favo

ur o

f hom

eopa

thy

(P <

0.0

5).

Stro

ng

Chi

ldre

n w

ith

acut

e ot

itis

med

ia w

ere

enro

lled

in

the

stud

y at

the

tim

e of

dia

gnos

is a

nd r

ando

miz

ed

to r

ecei

ve e

ithe

r st

anda

rd th

erap

y al

one

or

stan

dard

ther

apy

plus

a h

omeo

path

ic e

ar d

rop

solu

tion

that

was

to b

e us

ed o

n as

nee

ded

basi

s fo

r up

to 5

day

s.

Tayl

or JA

, Jac

obs

J (20

11).

Hom

eopa

thic

ear

dro

ps a

s an

ad

junc

t to

stan

dard

ther

apy

in c

hild

ren

wit

h ac

ute

otit

is m

edia

. H

omeo

path

y, 1

00(3

):10

9-15

.

A to

tal o

f 119

elig

ible

chi

ldre

n w

ere

enro

lled

in th

e st

udy;

sy

mpt

om d

iari

es w

ere

rece

ived

from

94

(79%

). S

ympt

om

scor

es te

nded

to b

e lo

wer

in th

e gr

oup

of c

hild

ren

rece

ivin

g ea

r dr

ops

than

in th

ose

rece

ivin

g st

anda

rd th

erap

y al

one;

th

ese

diff

eren

ces

wer

e si

gnifi

cant

at t

he s

econ

d an

d th

ird

asse

ssm

ents

(P =

0.0

4 an

d P

= 0

.003

, res

pect

ivel

y). I

n ad

diti

on,

the

rate

of s

ympt

om im

prov

emen

t was

fast

er in

chi

ldre

n in

the

ear

drop

gro

up c

ompa

red

wit

h ch

ildre

n in

sta

ndar

d th

erap

y al

one

grou

p (P

= 0

.002

).

Stro

ng

A r

ando

miz

ed p

lace

bo-c

ontr

olle

d pa

ralle

l gro

up

pilo

t stu

dy o

f hom

eopa

thic

vs

conv

enti

onal

tr

eatm

ent f

or a

cute

oti

tis

med

ia. P

atie

nts

wer

e ra

ndom

ized

by

a co

mpu

ter

gene

rate

d ra

ndom

nu

mbe

r lis

t to

rece

ive

eith

er in

divi

dual

ized

ho

meo

path

ic m

edic

ines

in fi

fty

mill

esim

al (L

M)

pote

ncie

s, o

r co

nven

tion

al tr

eatm

ent i

nclu

ding

an

alge

sics

, ant

ipyr

etic

s an

d an

ti-i

nflam

mat

ory

drug

s. P

atie

nts

who

did

not

impr

ove

wer

e pr

escr

ibed

ant

ibio

tics

at t

he 3

rd d

ay. O

utco

mes

w

ere

asse

ssed

by

the

Acu

te O

titi

s M

edia

-Sev

erit

y of

Sym

ptom

s (A

OM

-SO

S) S

cale

and

Tym

pani

c M

embr

ane

Exam

inat

ion

over

21

days

.

Sinh

a M

N, S

iddi

qui V

A, N

ayak

C, S

ingh

V, D

ixit

R, D

ewan

D,

Mis

hra

A (2

012)

. Ran

dom

ized

con

trol

led

pilo

t stu

dy to

com

pare

ho

meo

path

y an

d co

nven

tion

al th

erap

y in

acu

te o

titi

s m

edia

. H

omeo

path

y, 1

01: 5

-12.

81 p

atie

nts

wer

e in

clud

ed, 8

0 co

mpl

eted

follo

w-u

p: 4

1 fo

r co

nven

tion

al a

nd 4

0 fo

r ho

meo

path

ic tr

eatm

ent.

In th

e co

nven

tion

al g

roup

, all

40 (1

00%

) pat

ient

s w

ere

cure

d, in

the

hom

eopa

thy

grou

p, 3

8 (9

5%) p

atie

nts

wer

e cu

red

whi

le 0

2 (5

%) p

atie

nts

wer

e lo

st to

the

last

two

follo

w-u

p. B

y th

e 3r

d da

y of

trea

tmen

t, 4

pat

ient

s w

ere

cure

d in

Hom

eopa

thy

grou

p bu

t in

conv

enti

onal

gro

up o

nly

one

pati

ent w

as c

ured

. In

the

conv

enti

onal

gro

up a

ntib

ioti

cs w

ere

pres

crib

ed in

39

(97.

5%),

no

ant

ibio

tics

wer

e re

quir

ed in

the

hom

eopa

thy

grou

p. 8

5% o

f pa

tien

ts w

ere

pres

crib

ed s

ix h

omeo

path

ic m

edic

ines

.

Non

e(N

on-

conc

lusi

ve)

A p

rosp

ecti

ve r

ando

miz

ed, d

oubl

e-bl

ind

stud

y in

clud

ing

144

pati

ents

wit

h ac

ute

rhin

osin

usit

is.

The

y re

ceiv

ed e

ithe

r a

hom

eopa

thic

rem

edy

(n=

72) o

r pl

aceb

o (n

=72

). A

t the

con

trol

ex

amin

atio

ns a

fter

7, 1

4 an

d 21

day

s, fi

ve

sinu

siti

s-ty

pica

l sym

ptom

s w

ere

mea

sure

d w

ith

scor

es fr

om 0

(abs

ent)

to 4

(ver

y st

rong

).

Frie

se K

-H, Z

abal

otny

i DI (

2007

) Hom

öopa

thie

bei

aku

ter

Rhi

nosi

nusi

tis.

Ein

e do

ppel

blin

de, p

lace

boko

ntro

llier

te

Stud

ie b

eleg

t die

Wir

ksam

keit

und

Ver

träg

lichk

eit e

ines

ho

möo

path

isch

en K

ombi

nati

ons-

arzn

eim

itte

ls [

Hom

eopa

thy

in a

cute

rhi

nosi

nusi

tis.

A d

oubl

e-bl

ind,

pla

cebo

con

trol

led

stud

y sh

ows

the

effe

ctiv

enes

s an

d to

lera

bilit

y of

a h

omeo

path

ic

com

bina

tion

rem

edy]

. HN

O, 5

5: 2

71-7

.

In th

e ho

meo

path

ic tr

eatm

ent g

roup

, the

ave

rage

sum

sco

re

drop

ped

from

init

ially

12.

1+/-

1.6

to 5

.9+

/-2.

0 po

ints

aft

er 7

da

ys. I

n th

e pl

aceb

o gr

oup

it d

ecre

ased

from

11.

7+/-

1.6

to

11.0

+/-

2.9

poin

ts (p

<0.

0001

). T

he h

omeo

path

ic tr

eatm

ent

resu

lted

in fr

eedo

m fr

om c

ompl

aint

s in

90.

3% o

f the

pat

ient

s an

d im

prov

emen

t in

a fu

rthe

r 8.

3%, w

here

as in

the

plac

ebo

grou

p, th

e co

mpl

aint

s re

mai

ned

unch

ange

d or

bec

ame

wor

se

in 8

8.9%

of t

he p

atie

nts.

Stro

ng

A p

rosp

ecti

ve, r

ando

miz

ed, d

oubl

e-bl

ind,

pl

aceb

o-co

ntro

lled,

pha

se II

I clin

ical

tria

l was

co

nduc

ted

for

a tr

eatm

ent p

erio

d of

22

days

, fo

llow

ed b

y an

eig

ht-w

eek

post

-tre

atm

ent

obse

rvat

iona

l pha

se. 1

13 p

atie

nts

wit

h ra

diog

raph

y-co

nfirm

ed A

MS

part

icip

ated

in th

e tr

ial.

Zabo

lotn

yi D

I, K

neis

KC

, Ric

hard

son

A e

t al (

2007

). E

ffica

cy o

f a

com

plex

hom

eopa

thic

med

icat

ion

(Sin

fron

tal)

in p

atie

nts

wit

h ac

ute

max

illar

y si

nusi

tis:

a p

rosp

ecti

ve, r

ando

miz

ed, d

oubl

e-bl

ind,

pla

cebo

-con

trol

led,

mul

tice

ntre

clin

ical

tria

l. Ex

plor

e (N

Y),

3: 9

8-10

9.

From

day

zer

o to

day

sev

en, S

infr

onta

l cau

sed

a si

gnifi

cant

re

duct

ion

in th

e SS

S to

tal s

core

com

pare

d w

ith

plac

ebo

(5.8

+/-

2.

3 [6

.0]

poin

ts v

s 2.

3 +

/- 1

.8 [

2.0]

poi

nts;

P <

.000

1). O

n da

y 21

, 39

(68.

4%) p

atie

nts

on a

ctiv

e m

edic

atio

n ha

d a

com

plet

e re

mis

sion

of A

MS

sym

ptom

s co

mpa

red

wit

h fi

ve (8

.9%

) pl

aceb

o pa

tien

ts. A

ll se

cond

ary

outc

ome

crit

eria

dis

play

ed

sim

ilar

tren

ds. E

ight

adv

erse

eve

nts

wer

e re

port

ed th

at w

ere

asse

ssed

as

bein

g m

ild o

r m

oder

ate

in in

tens

ity.

No

recu

rren

ce

of A

MS

sym

ptom

s oc

curr

ed b

y th

e en

d of

the

eigh

t-w

eek

post

-tr

eatm

ent o

bser

vati

onal

pha

se.

Stro

ng

21

A r

ando

miz

ed p

lace

bo-c

ontr

olle

d cl

inic

al tr

ial

to a

sses

s th

e ef

fect

iven

ess

of a

hom

eopa

thic

pr

epar

atio

n in

the

trea

tmen

t of i

nflue

nza-

like

synd

rom

es, i

nclu

ding

372

pat

ient

s.

Papp

, R, S

chub

ack

G e

t al (

1998

). O

scill

ococ

cinu

m®

in p

atie

nts

wit

h in

flue

nza-

like

synd

rom

es: a

pla

cebo

-con

trol

led

doub

le-

blin

d ev

alua

tion

. Bri

tish

Hom

eopa

thic

Jour

nal,

87:6

9-76

.

Aft

er 4

8 ho

urs

the

sym

ptom

s of

the

pati

ents

in th

e ve

rum

gr

oup

wer

e si

gnifi

cant

ly m

ilder

(p=

0.02

3) th

an in

the

plac

ebo

grou

p. T

he n

umbe

r of

pat

ient

s w

ith

no s

ympt

oms

was

sig

nifi

cant

ly h

ighe

r in

the

veru

m g

roup

from

the

seco

nd

day

onw

ards

(ver

um: 1

7.4%

, pla

cebo

: 6.6

%) u

ntil

the

end

of

the

pati

ents

’ rec

ordi

ng (d

ay 5

in th

e ev

enin

g: v

erum

: 73.

7%,

plac

ebo:

63.

7%).

The

big

gest

gro

up d

iffe

renc

e w

as r

ecor

ded

for

the

tim

e be

twee

n th

e ev

enin

g of

the

seco

nd d

ay (1

0.6%

m

ore

pati

ents

wit

h no

sym

ptom

s) a

nd th

e m

orni

ng o

f the

fo

urth

day

(10.

2% m

ore

pati

ents

wit

h no

sym

ptom

s).

Mod

erat

e

A m

ulti

cent

er, p

rosp

ecti

ve, r

ando

miz

ed, t

ripl

e-ar

m p

lace

bo c

ontr

olle

d tr

ial c

ondu

cted

at n

ine

Inst

itut

es a

nd U

nits

of C

entr

al C

ounc

il fo

r R

esea

rch

in H

omoe

opat

hy (C

CR

H) f

rom

June

20

09 to

Dec

embe

r 20

10. T

he p

atie

nts

fulfi

lling

th

e in

clus

ion

crit

eria

wer

e ra

ndom

ized

to L

M,

cent

esim

al a

nd p

lace

bo g

roup

s.

Cha

krab

orty

PS,

Lam

ba C

D e

t al (

2013

). E

ffec

t of i

ndiv

idua

lized

ho

moe

opat

hic

trea

tmen

t in

infl

uenz

a-lik

e ill

ness

: A m

ulti

cent

er,

sing

le b

lind,

ran

dom

ized

, pla

cebo

-con

trol

led

stud

y. In

dian

Jo

urna

l of R

esea

rch

in H

omoe

opat

hy, 7

: 22-

30.

Out

of 7

39 s

cree

ned

case

s, 4

47 c

ases

wer

e el

igib

le fo

r en

rolm

ent c

ompr

isin

g LM

(n=

152)

, cen

tesi

mal

(n=

147)

and

pl

aceb

o (n

=14

8) c

ases

. The

re w

as a

sig

nifi

cant

dif

fere

nce

in te

mpe

ratu

re fr

om 2

nd d

ay o

nwar

ds in

LM

and

cen

tesi

mal

gr

oups

. Con

clus

ion:

The

stu

dy r

evea

led

the

sign

ifica

nt e

ffec

t of

indi

vidu

aliz

ed h

omoe

opat

hic

trea

tmen

t in

the

pati

ents

su

ffer

ing

from

infl

uenz

a lik

e ill

ness

wit

h no

sig

nifi

cant

di

ffer

ence

bet

wee

n LM

and

cen

tesi

mal

gro

ups.

The

co

mpl

icat

ion/

sequ

el r

ate

was

als

o si

gnifi

cant

ly le

ss in

the

inte

rven

tion

gro

ups

com

pare

d to

the

plac

ebo

grou

p.

Mod

erat

e

A r

ando

miz

ed d

oubl

e bl

ind

plac

ebo

cont

rolle

d st

udy

incl

udin

g 17

5 ch

ildre

n w

ith

freq

uent

ly

recu

rrin

g up

per

resp

irat

ory

trac

t inf

ecti

ons.

Of

the

170

child

ren

eval

uabl

e, 8

6 w

ere

rand

omiz

ed to

ho

meo

path

ic m

edic

ines

and

84

to p

lace

bo.

de L

ange

de

Kle

rk E

SM, B

lom

mer

s J e

t al (

1994

). E

ffec

ts o

f ho

moe

opat

hic

med

icin

es o

n da

ily b

urde

n of

sym

ptom

s in

ch

ildre

n w

ith

recu

rren

t upp

er r

espi

rato

ry tr

act i

nfec

tion

s. B

ritis

h M

edic

al Jo

urna

l, 30

9:13

29–1

332.

The

mea

n da

ily s

ympt

om s

core

was

2.6

1 in

the

plac

ebo

grou

p an

d 2.

21 in

the

trea

tmen

t gro

up (d

iffe

renc

e 0.

41; 9

5%

confi

denc

e in

terv

al -0

.02

to 0

.83)

. In

both

gro

ups

the

use

of

anti

biot

ics

was

gre

atly

red

uced

com

pare

d w

ith

that

in th

e ye

ar

befo

re e

nter

ing

the

tria

l (fr

om 7

3 to

33

in th

e tr

eatm

ent g

roup

an

d fr

om 6

9 to

43

in th

e pl

aceb

o gr

oup)

. The

pro

port

ion

of

child

ren

in th

e tr

eatm

ent g

roup

hav

ing

aden

oide

ctom

ies

was

lo

wer

in th

e tr

eatm

ent g

roup

(16%

, 8/5

0) th

an in

the

plac

ebo

grou

p (2

1%, 9

/42)

. The

pro

port

ion

havi

ng to

nsill

ecto

mie

s w

as

the

sam

e in

bot

h gr

oups

(5%

).

Non

e(N

on-

conc

lusi

ve)

A d

oubl

e-bl

ind

rand

omiz

ed p

aral

lel g

roup

pl

aceb

o co

ntro

lled

tria

l in

251

child

ren

belo

w

the

age

of 1

0 ye

ars,

rec

ruit

ed b

y po

st fr

om

thos

e pr

evio

usly

dia

gnos

ed w

ith

UR

TI w

hen

atte

ndin

g a

casu

alty

dep

artm

ent.

The

chi

ldre

n re

ceiv

ed e

ithe

r pl

aceb

o or

ult

ram

olec

ular

ho

meo

path

ic m

edic

ines

in C

-30

pote

ncy

(dilu

ted

10-6

0) a

dmin

iste

red

twic

e w

eekl

y fo

r 12

wee

ks.

Pare

nts

chos

e th

e m

edic

ine

base

d on

sim

plifi

ed

cons

titu

tion

al in

dica

tion

s.

Stei

nsbe

kk A

, Ben

tzen

N, F

ønne

bø V

, Lew

ith

G (2

005)

. Sel

f tr

eatm

ent w

ith

one

of th

ree

self

sel

ecte

d, u

ltra

mol

ecul

ar

hom

eopa

thic

med

icin

es fo

r th

e pr

even

tion

of u

pper

res

pira

tory

tr

act i

nfec

tion

s in

chi

ldre

n. A

dou

ble-

blin

d ra

ndom

ized

pla

cebo

co

ntro

lled

tria

l. Br

itish

Jour

nal o

f Clin

ical

Pha

rmac

olog

y, 5

9:44

7–45

5.

The

re w

as n

o di

ffer

ence

in th

e pr

edefi

ned

prim

ary

outc

ome

betw

een

the

two

grou

ps (P

= 0

.733

). M

edia

n U

RT

I sco

res

over

12

wee

ks in

the

hom

eopa

thic

med

icin

e gr

oup

wer

e 26

.0 (9

5%

confi

denc

e in

terv

al (C

I) 1

6.3,

43.

7) a

nd fo

r pl

aceb

o 25

.0 (9

5%

CI 1

4.2,

38.

4). T

here

was

no

stat

isti

cal d

iffe

renc

e be

twee

n th

e tw

o gr

oups

in m

edia

n nu

mbe

r of

day

s w

ith

UR

TI s

ympt

oms

or

in th

e us

e of

con

vent

iona

l med

icat

ion/

care

.

Non

e(N

on-

conc

lusi

ve)

Ope

n, p

ragm

atic

, ran

dom

ised

par

alle

l-gr

oup

tria

l wit

h w

aiti

ng-l

ist g

roup

as

cont

rol,

incl

udin

g 16

9 ch

ildre

n be

low

the

age

of 1

0 ye

ars,

rec

ruit

ed

by p

ost f

rom

chi

ldre

n pr

evio

usly

dia

gnos

ed

wit

h U

RT

I. T

hey

rece

ived

eit

her

prag

mat

ic

hom

eopa

thic

car

e fr

om o

ne o

f five

hom

eopa

ths

for

12 w

eeks

or

wer

e as

sign

ed to

a w

aiti

ng-l

ist

cont

rol u

sing

sel

f-se

lect

ed, c

onve

ntio

nal h

ealt

h ca

re.

Stei

nsbe

kk A

, Føn

nebø

V, L

ewit

h G

, Ben

tzen

N (2

005)

. H

omeo

path

ic c

are

for

the

prev

enti

on o

f upp

er r

espi

rato

ry tr

act

infe

ctio

ns in

chi

ldre

n: a

pra

gmat

ic, r

ando

miz

ed, c

ontr

olle

d tr

ial c

ompa

ring

ran

dom

ized

hom

eopa

thic

car

e an

d w

aiti

ng-l

ist

cont

rols

. Com

plem

enta

ry T

hera

pies

in M

edic

ine,

13:

231–

238.

The

re w

as a

sig

nifi

cant

dif

fere

nce

in m

edia

n to

tal s

ympt

om

scor

e in

favo

ur o

f hom

eopa

thic

car

e (2

4 po

ints

) com

pare

d to

th

e co

ntro

l gro

up (4

4 po

ints

) (p

= 0

.026

). T

he d

iffe

renc

e in

the

med

ian

num

ber

of d

ays

wit

h U

RT

I sym

ptom

s w

as s

tati

stic

ally

si

gnifi

cant

wit

h 8

days

in th

e ho

meo

path

ic g

roup

and

13

days

in

the

cont

rol g

roup

(p =

0.0

06).

The

re w

as n

o st

atis

tica

l di

ffer

ence

in th

e us

e of

con

vent

iona

l med

icat

ion

or c

are

betw

een

the

two

grou

ps.

Mod

erat

e

22

A r

ando

miz

ed p

lace

bo-c

ontr

olle

d cl

inic

al tr

ial

to a

sses

s th

e ef

fect

iven

ess

of a

hom

eopa

thic

pr

epar

atio

n in

the

trea

tmen

t of i

nflue

nza-

like

synd

rom

es, i

nclu

ding

372

pat

ient

s.

Papp

, R, S

chub

ack

G e

t al (

1998

). O

scill

ococ

cinu

m®

in p

atie

nts

wit

h in

flue

nza-

like

synd

rom

es: a

pla

cebo

-con

trol

led

doub

le-

blin

d ev

alua

tion

. Bri

tish

Hom

eopa

thic

Jour

nal,

87:6

9-76

.

Aft

er 4

8 ho

urs

the

sym

ptom

s of

the

pati

ents

in th

e ve

rum

gr

oup

wer

e si

gnifi

cant

ly m

ilder

(p=

0.02

3) th

an in

the

plac

ebo

grou

p. T

he n

umbe

r of

pat

ient

s w

ith

no s

ympt

oms

was

sig

nifi

cant

ly h

ighe

r in

the

veru

m g

roup

from

the

seco

nd

day

onw

ards

(ver

um: 1

7.4%

, pla

cebo

: 6.6

%) u

ntil

the

end

of

the

pati

ents

’ rec

ordi

ng (d

ay 5

in th

e ev

enin

g: v

erum

: 73.

7%,

plac

ebo:

63.

7%).

The

big

gest

gro

up d

iffe

renc

e w

as r

ecor

ded

for

the

tim

e be

twee

n th

e ev

enin

g of

the

seco

nd d

ay (1

0.6%

m

ore

pati

ents

wit

h no

sym

ptom

s) a

nd th

e m

orni

ng o

f the

fo

urth

day

(10.

2% m

ore

pati

ents

wit

h no

sym

ptom

s).

Mod

erat

e

A m

ulti

cent

er, p

rosp

ecti

ve, r

ando

miz

ed, t

ripl

e-ar

m p

lace

bo c

ontr

olle

d tr

ial c

ondu

cted

at n

ine

Inst

itut

es a

nd U

nits

of C

entr

al C

ounc

il fo

r R

esea

rch

in H

omoe

opat

hy (C

CR

H) f

rom

June

20

09 to

Dec

embe

r 20

10. T

he p

atie

nts

fulfi

lling

th

e in

clus

ion

crit

eria

wer

e ra

ndom

ized

to L

M,

cent

esim

al a

nd p

lace

bo g

roup

s.

Cha

krab

orty

PS,

Lam

ba C

D e

t al (

2013

). E

ffec

t of i

ndiv

idua

lized

ho

moe

opat

hic

trea

tmen

t in

infl

uenz

a-lik

e ill

ness

: A m

ulti

cent

er,

sing

le b

lind,

ran

dom

ized

, pla

cebo

-con

trol

led

stud

y. In

dian

Jo

urna

l of R

esea

rch

in H

omoe

opat

hy, 7

: 22-

30.

Out

of 7

39 s

cree

ned

case

s, 4

47 c

ases

wer

e el

igib

le fo

r en

rolm

ent c

ompr

isin

g LM

(n=

152)

, cen

tesi

mal

(n=

147)

and

pl

aceb

o (n

=14

8) c

ases

. The

re w

as a

sig

nifi

cant

dif

fere

nce

in te

mpe

ratu

re fr

om 2

nd d

ay o

nwar

ds in

LM

and

cen

tesi

mal

gr

oups

. Con

clus

ion:

The

stu

dy r

evea

led

the

sign

ifica

nt e

ffec

t of

indi

vidu

aliz

ed h

omoe

opat

hic

trea

tmen

t in

the

pati

ents

su

ffer

ing

from

infl

uenz

a lik

e ill

ness

wit

h no

sig

nifi

cant

di

ffer

ence

bet

wee

n LM

and

cen

tesi

mal

gro

ups.

The

co

mpl

icat

ion/

sequ

el r

ate

was

als

o si

gnifi

cant

ly le

ss in

the

inte

rven

tion

gro

ups

com

pare

d to

the

plac

ebo

grou

p.

Mod

erat

e

A r

ando

miz

ed d

oubl

e bl

ind

plac

ebo

cont

rolle

d st

udy

incl

udin

g 17

5 ch

ildre

n w

ith

freq

uent

ly

recu

rrin

g up

per

resp

irat

ory

trac

t inf

ecti

ons.

Of

the

170

child

ren

eval

uabl

e, 8

6 w

ere

rand

omiz

ed to

ho

meo

path

ic m

edic

ines

and

84

to p

lace

bo.

de L

ange

de

Kle

rk E

SM, B

lom

mer

s J e

t al (

1994

). E

ffec

ts o

f ho

moe

opat

hic

med

icin

es o

n da

ily b

urde

n of

sym

ptom

s in

ch

ildre

n w

ith

recu

rren

t upp

er r

espi

rato

ry tr

act i

nfec

tion

s. B

ritis

h M

edic

al Jo

urna

l, 30

9:13

29–1

332.

The

mea

n da

ily s

ympt

om s

core

was

2.6

1 in

the

plac

ebo

grou

p an

d 2.

21 in

the

trea

tmen

t gro

up (d

iffe

renc

e 0.

41; 9

5%

confi

denc

e in

terv

al -0

.02

to 0

.83)

. In

both

gro

ups

the

use

of

anti

biot

ics

was

gre

atly

red

uced

com

pare

d w

ith

that

in th

e ye

ar

befo

re e

nter

ing

the

tria

l (fr

om 7

3 to

33

in th

e tr

eatm

ent g

roup

an

d fr

om 6

9 to

43

in th

e pl

aceb

o gr

oup)

. The

pro

port

ion

of

child

ren

in th

e tr

eatm

ent g

roup

hav

ing

aden

oide

ctom

ies

was

lo

wer

in th

e tr

eatm

ent g

roup

(16%

, 8/5

0) th

an in

the

plac

ebo

grou

p (2

1%, 9

/42)

. The

pro

port

ion

havi

ng to

nsill

ecto

mie

s w

as

the

sam

e in

bot

h gr

oups

(5%

).

Non

e(N

on-

conc

lusi

ve)

A d

oubl

e-bl

ind

rand

omiz

ed p

aral

lel g

roup

pl

aceb

o co

ntro

lled

tria

l in

251

child

ren

belo

w

the

age

of 1

0 ye

ars,

rec

ruit

ed b

y po

st fr

om

thos

e pr

evio

usly

dia

gnos

ed w

ith

UR

TI w

hen

atte

ndin

g a

casu

alty

dep

artm

ent.

The

chi

ldre

n re

ceiv

ed e

ithe

r pl

aceb

o or

ult

ram

olec

ular

ho

meo

path

ic m

edic

ines

in C

-30

pote

ncy

(dilu

ted

10-6

0) a

dmin

iste

red

twic

e w

eekl

y fo

r 12

wee

ks.

Pare

nts

chos

e th

e m

edic

ine

base

d on

sim

plifi

ed

cons

titu

tion

al in

dica

tion

s.

Stei

nsbe

kk A

, Ben

tzen

N, F

ønne

bø V

, Lew

ith

G (2

005)

. Sel

f tr

eatm

ent w

ith

one

of th

ree

self

sel

ecte

d, u

ltra

mol

ecul

ar

hom

eopa

thic

med

icin

es fo

r th

e pr

even

tion

of u

pper

res

pira

tory

tr

act i

nfec

tion

s in

chi

ldre

n. A

dou

ble-

blin

d ra

ndom

ized

pla

cebo

co

ntro

lled

tria

l. Br

itish

Jour

nal o

f Clin

ical

Pha

rmac

olog

y, 5

9:44

7–45

5.

The

re w

as n

o di

ffer

ence

in th

e pr

edefi

ned

prim

ary

outc

ome

betw

een

the

two

grou

ps (P

= 0

.733

). M

edia

n U

RT

I sco

res

over

12

wee

ks in

the

hom

eopa

thic

med

icin

e gr

oup

wer

e 26

.0 (9

5%

confi

denc

e in

terv

al (C

I) 1

6.3,

43.

7) a

nd fo

r pl

aceb

o 25

.0 (9

5%

CI 1

4.2,

38.

4). T

here

was

no

stat

isti

cal d

iffe

renc

e be

twee

n th

e tw

o gr

oups

in m

edia

n nu

mbe

r of

day

s w

ith

UR

TI s

ympt

oms

or

in th

e us

e of

con

vent

iona

l med

icat

ion/

care

.

Non

e(N

on-

conc

lusi

ve)

Ope

n, p

ragm

atic

, ran

dom

ised

par

alle

l-gr

oup

tria

l wit

h w

aiti

ng-l

ist g

roup

as

cont

rol,

incl

udin

g 16

9 ch

ildre

n be

low

the

age

of 1

0 ye

ars,

rec

ruit

ed

by p

ost f

rom

chi

ldre

n pr

evio

usly

dia

gnos

ed

wit

h U

RT

I. T

hey

rece

ived

eit

her

prag

mat

ic

hom

eopa

thic

car

e fr

om o

ne o

f five

hom

eopa

ths

for

12 w

eeks

or

wer

e as

sign

ed to

a w

aiti

ng-l

ist

cont

rol u

sing

sel

f-se

lect

ed, c

onve

ntio

nal h

ealt

h ca

re.

Stei

nsbe

kk A

, Føn

nebø

V, L

ewit

h G

, Ben

tzen

N (2

005)

. H

omeo

path

ic c

are

for

the

prev

enti

on o

f upp

er r

espi

rato

ry tr

act

infe

ctio

ns in

chi

ldre

n: a

pra

gmat

ic, r

ando

miz

ed, c

ontr

olle

d tr

ial c

ompa

ring

ran

dom

ized

hom

eopa

thic

car

e an

d w

aiti

ng-l

ist

cont

rols

. Com

plem

enta

ry T

hera

pies

in M

edic

ine,

13:

231–

238.

The

re w

as a

sig

nifi

cant

dif

fere

nce

in m

edia

n to

tal s

ympt

om

scor

e in

favo

ur o

f hom

eopa

thic

car

e (2

4 po

ints

) com

pare

d to

th

e co

ntro

l gro

up (4

4 po

ints

) (p

= 0

.026

). T

he d

iffe

renc

e in

the

med

ian

num

ber

of d

ays

wit

h U

RT

I sym

ptom

s w

as s

tati

stic

ally

si

gnifi

cant

wit

h 8

days

in th

e ho

meo

path

ic g

roup

and

13

days

in

the

cont

rol g

roup

(p =

0.0

06).

The

re w

as n

o st

atis

tica

l di

ffer

ence

in th

e us

e of

con

vent

iona

l med

icat

ion

or c

are

betw

een

the

two

grou

ps.

Mod

erat

e

TA

BL

E 3

: A

NT

HR

OP

OS

OP

HIC

ME

DIC

INE

IN

UP

PE

R A

ND

LO

WE

R R

ES

PIR

AT

OR

Y T

RA

CT

IN

FE

CT

ION

S

ST

UD

Y D

ES

IGN

PU

BLI

CA

TIO

N D

ET

AIL

SM

AIN

FIN

DIN

GS

ST

RE

NG

TH

O

F E

VID

EN

CE

Obs

erva

tion

al c

ase

seri

es fr

om a

n In

tegr

ativ

e-M

edic

ine

unit

usi

ng a

nthr

opos

ophi

c m

edic

ines

wit

hin

a un

iver

sity

te

achi

ng h

ospi

tal.

Gey

er U

, Die

deri

ch K

, Kus

sero

w M

, Lau

bers

heim

er A

, K

ram

er K

(201

3). I

npat

ient

trea

tmen

t of c

omm

unit

y-ac

quir

ed

pneu

mon

ias

wit

h in

tegr

ativ

e m

edic

ine.

Evi

denc

e Bas

ed

Com

plem

enta

ry A

ltern

ativ

e Med

icin

e, 2

013:

578

274.

16/1

8 pa

tien

ts w

ith

com

mun

ity-

acqu

ired

pne

umon

ia

coul

d be

cur

ed s

ucce

ssfu

lly b

y ap

plic

atio

n of

AM

m

edic

ine

only

, usi

ng A

M m

edic

ines

and

ext

erna

l ap

plic

atio

ns li

ke c

ompr

esse

s an

d em

broc

atio

ns.

The

pne

umon

ia s

ever

ity

inde

x (P

SI) w

as u

sed

to e

stim

ate

the

seve

rity

of p

neum

onia

. 2/1

8 pa

tien

ts n

eede

d an

tibi

otic

th

erap

y in

add

itio

n. 1

5/16

pat

ient

s w

itho

ut a

ntib

ioti

c tr

eatm

ent b

elon

ged

to r

isk

grou

ps I-

III (

low

and

mod

erat

e ri

sk) a

nd o

ne p

atie

nt to

ris

k gr

oup

V (h

igh

risk

). B

oth

pati

ents

wit

h an

tibi

otic

trea

tmen

t bel

onge

d to

ris

k gr

oup

IV.

Thu

s, it

was

sho

wn

that

in s

peci

aliz

ed u

nits

trea

tmen

t of

sev

ere

infe

ctio

us c

ondi

tion

s lik

e pn

eum

onia

by

AM

is

poss

ible

and

will

lead

to a

sig

nifi

cant

ly r

educ

ed n

eed

for

anti

biot

ics.

Mod

erat

e

GC

P-co

nfor

m p

rosp

ecti

ve o

bser

vati

onal

non

rand

omis

ed

com

para

tive

out

com

es s

tudy

incl

udin

g 21

pri

mar

y ca

re

cent

res

in 4

Eur

opea

n co

untr

ies

and

the

US.

715

pat

ient

s w

ith

acut

e re

spir

ator

y an

d ea

r in

fect

ions

trea

ted

by

27 a

nthr

opos

ophi

c ph

ysic

ians

wer

e co

mpa

red

to 3

01

pati

ents

trea

ted

by 1

6 co

nven

tion

al p

hysi

cian

s.

Ham

re H

J, F

isch

er M

et a

l. (2

005)

. Ant

hrop

osop

hic

vs.

conv

enti

onal

ther

apy

of a

cute

res

pira

tory

and

ear

infe

ctio

ns: a

pr

ospe

ctiv

e ou

tcom

es s

tudy

. Wie

ner k

linis

che W

oche

nsch

rift,

117

, 25

6–26

8

Impr

ovem

ent w

ithi

n 24

hou

rs o

ccur

red

in 3

0.9%

(2

21/7

15) o

f pat

ient

s tr

eate

d by

AM

doc

tors

and

16.

6%

(50/

301)

of p

atie

nts

trea

ted

by c

onve

ntio

nal d

octo

rs.

Day

7 c

ompl

ete

reco

very

or

maj

or im

prov

emen

t was

re

port

ed b

y 77

.1%

(AM

doc

tors

) vs.

66.

1% o

f pat

ient

s (c

onve

ntio

nal d

octo

rs),

res

pect

ivel

y. A

ntib

ioti

cs w

ere

used

in 5

,5%

of p

atie

nts

in th

e an

thro

poso

phic

doc

tors

gr

oup

com

pare

d to

33,

6% in

the

conv

enti

onal

gro

up.

Stro

ng

GC

P-co

nfor

m p

rosp

ecti

ve o

bser

vati

onal

non

rand

omis

ed

com

para

tive

coh

ort s

tudy

incl

udin

g 21

pri

mar

y ca

re

cent

res

in 4

Eur

opea

n co

untr

ies

and

the

US.

Ham

re H

J, F

isch

er M

et a

l. (2

007)

. Use

and

Saf

ety

of

Ant

hrop

osop

hic

Med

icat

ions

for

Acu

te R

espi

rato

ry a

nd E

ar

Infe

ctio

ns: A

Pro

spec

tive

Coh

ort S

tudy

. Dru

g Ta

rget

Insi

ghts

, 2,

209–

219.

The

saf

ety

anal

ysis

of t

he A

M m

edic

ines

use

d sh

owed

that

A

DR

´s w

ere

rare

(2/7

15 p

atie

nts)

and

mild

. In

one

case

, th

ere

was

sle

eple

ssne

ss a

t nig

ht, i

n th

e ot

her

case

loca

l sw

ellin

g du

e to

sub

cuta

neou

s in

ject

ion

of a

n A

M r

emed

y.

AD

R´s

thus

occ

urre

d at

a s

igni

fica

ntly

low

er p

erce

ntag

e th

an w

ith

conv

enti

onal

trea

tmen

t.

Stro

ng

Larg

e m

ulti

-cen

tre

pros

pect

ive

obse

rvat

iona

l stu

dy in

A

M p

rim

ary

care

cen

tres

in G

erm

any

incl

udin

g 12

,081

pa

tien

ts w

ith

19,0

50 a

cute

upp

er a

irw

ay in

fect

ions

in

clud

ing

com

mon

col

d (6

3,3%

) and

tons

illit

is (1

2,9%

).

73,7

% o

f pat

ient

s w

ere

child

ren.

Jesc

hke

E, L

üke

C e

t al.

(200

7). V

eror

dnun

gsve

rhal

ten

anth

ropo

soph

isch

ori

enti

erte

r Ä

rzte

bei

aku

ten

Infe

ktio

nen

der

ober

en A

tem

weg

e [P

resc

ribi

ng p

ract

ices

in th

e tr

eatm

ent

of u

pper

res

pira

tory

trac

t inf

ecti

ons

in a

nthr

opos

ophi

c m

edic

ine]

. For

sche

nde K

ompl

emen

tärm

ediz

in, 1

4, 2

07-2

15.

In 6

3%, t

reat

men

t was

pur

ely

anth

ropo

soph

ic. I

n on

ly

6,3%

of c

ases

ant

ibio

tics

wer

e us

ed. W

ithi

n th

e gr

oup

of th

e 8,

900

child

ren

show

ing

14,9

45 r

espi

rato

ry tr

act

infe

ctio

ns, a

ntib

ioti

c pr

escr

ipti

ons

occu

rred

in o

nly

5,8%

.

Stro

ng

23

TA

BL

E 4

: H

OM

EO

PA

TH

Y I

N A

NIM

AL

S W

ITH

IN

FE

CT

IOU

S D

ISE

AS

ES

(R

AN

DO

MIS

ED

CO

NT

RO

LL

ED

TR

IAL

S O

NL

Y)

ST

UD

Y D

ES

IGN

PU

BLI

CA

TIO

N D

ET

AIL

SM

AIN

FIN

DIN

GS

ST

RE

NG

TH

O

F E

VID

EN

CE

Ran

dom

ised

pla

cebo

-con

trol

led

tria

l on

104

cow

s w

ith

subc

linic

al m

asti

tis.

Six

dif

fere

nt h

omeo

path

ic

med

icin

es w

ere

com

pare

d w

ith

plac

ebo.

Intr

a-m

amm

ary

appl

icat

ion

of 1

ml o

f the

hom

eopa

thic

med

icin

e or

is

oton

ic s

alin

e so

luti

on a

s pl

aceb

o.

And

erss

on R

, Mor

cillo

LL,

Som

mer

H (1

997)

. U

nter

such

unge

n üb

er d

en E

insa

tz v

on

hom

öopa

this

chen

Arz

neim

itte

ln b

ei d

er B

ehan

dlun

g un

d Pr

ophy

laxe

sub

klin

isch

er M

asti

tide

n vo

n M

ilchk

ühen

[Tr

eatm

ent a

nd p

roph

ylax

is o

f sub

clin

ical

m

asti

tis

wit

h ho

meo

path

ic d

rugs

]. T

ierä

rztli

che U

msc

hau,

52

: 407

–412

.

Non

e of

the

hom

eopa

thic

dru

gs s

how

ed a

pro

phyl

acti

c ef

fect

. Fou

r of

the

six

hom

eopa

thic

med

icin

es d

id n

ot s

how

a

ther

apeu

tic

effe

ct. O

nly

Lach

esis

D8

and

Silic

ea D

6 in

mas

titi

s ca

used

by

Stap

hylo

cocc

us a

ureu

s ha

d a

ther

apeu

tic

effe

ct, i

.e.

a si

gnifi

cant

dec

reas

e of

cel

ls in

the

milk

and

LD

H (l

acta

te

dehy

drog

enas

e) b

lood

leve

l.

Prel

imin

ary

Ran

dom

ized

pla

cebo

-con

trol

led

tria

l inc

ludi

ng 2

6 co

ws,

di

vide

d in

2 g

roup

s, p

airi

ng o

n cl

inic

al a

nd s

ubcl

inic

al

mas

titi

s st

atus

, milk

pro

duct

ion

and

num

ber

of

lact

atio

ns.

Sear

cy R

, Rey

es O

, Gua

jard

o G

(199

5). C

ontr

ol o

f su

bclin

ical

bov

ine

mas

titi

s. U

tiliz

atio

n of

a h

omeo

path

ic

com

bina

tion

. Bri

tish

Hom

eopa

thic

Jour

nal,

84: 6

7-70

.

The

pro

port

ion

of a

ffec

ted

quar

ters

(a c

ow’s

udd

er is

div

ided

up

into

four

qua

rter

s) a

ccor

ding

to th

e C

alif

orni

a M

asti

tis

Test

w

as 3

2% in

the

trea

ted

grou

p, a

nd 6

8% in

the

cont

rol g

roup

. T

he o

dds

rati

o of

the

diff

eren

ce s

how

s th

at a

nim

als

rece

ivin

g pl

aceb

o pr

esen

ted

4.5

(1.7

8-11

.73)

tim

es m

ore

subc

linic

al

mas

titi

s th

an th

ose

unde

r ho

meo

path

ic tr

eatm

ent (

p<0.

05).

A

vera

ge m

ilk p

rodu

ctio

n in

the

trea

ted

grou

p di

d no

t dif

fer

sign

ifica

ntly

from

that

of t

he c

ontr

ol g

roup

.

Prel

imin

ary

Nin

ety-

six

mas

titi

c qu

arte

rs (n

on-fi

bros

ed 6

7 an

d fi

bros

ed 2

9) w

ere

trea

ted

wit

h a

hom

eopa

thic

co

mbi

nati

on m

edic

ine

Hea

lwel

l VT-

6 (c

onsi

stin

g of

Ph

ytol

acca

, Cal

care

a fl

uori

ca.,

Sili

ca, B

ella

donn

a,

Bry

onia

, Arn

ica,

Con

ium

and

Ipec

acua

nha)

. Ano

ther

96

quar

ters

wit

h ac

ute

mas

titi

s (n

on-fi

bros

ed) t

reat

ed w

ith

diff

eren

t ant

ibio

tics

wer

e in

clud

ed in

the

stud

y.

Vars

hney

JP, N

ares

h R

(200

5). C

ompa

rati

ve e

ffica

cy o

f ho

meo

path

ic a

nd a

llopa

thic

sys

tem

s of

med

icin

e in

the

man

agem

ent o

f clin

ical

mas

titi

s of

Indi

an d

airy

cow

s.

Hom

eopa

thy,

94:

81-

85.

The

ove

rall

effe

ctiv

enes

s of

hom

eopa

thic

com

bina

tion

med

icin

e in

the

trea

tmen

t of a

cute

non

-fibr

osed

mas

titi

s w

as 8

6.6%

w

ith

a m

ean

reco

very

per

iod

of 7

.7 d

ays

(ran

ge 3

–28)

, and

tota

l co

st o

f the

rapy

as

Indi

an R

upee

s 21

.4 (€

0.39

, US$

0.47

). T

he

corr

espo

ndin

g cu

re r

ate

for

the

anti

biot

ic g

roup

was

59.

2%

wit

h a

mea

n re

cove

ry p

erio

d of

4.5

day

s (r

ange

2–1

5) a

nd a

n av

erag

e tr

eatm

ent c

ost o

f Rs.

149.

20 (€

2.69

, US$

3.28

). T

he

auth

ors

conc

lude

that

the

hom

eopa

thic

com

bina

tion

med

icin

e H

ealw

ell V

T-6

was

eff

ecti

ve a

nd e

cono

mic

al in

the

man

agem

ent

of m

asti

tis

in la

ctat

ing

dair

y co

ws.

Prel

imin

ary

Ran

dom

ized

con

trol

led

tria

l com

pari

ng th

e ef

fect

iven

ess

of h

omeo

path

ic tr

eatm

ent w

ith

anti

biot

ic a

nd p

lace

bo

trea

tmen

ts in

cas

es o

f mild

and

mod

erat

e bo

vine

cl

inic

al m

asti

tis.

A to

tal o

f 136

lact

atin

g da

iry

cow

s w

ith

147

affe

cted

qua

rter

s fr

om fo

ur h

erds

in G

erm

any

wer

e ra

ndom

ly a

lloca

ted

to th

ree

trea

tmen

t gro

ups.

T

he c

ows

wer

e ex

amin

ed o

n da

ys 0

, 1, 2

and

on

days

7,

14,

28

and

56 p

ost i

niti

al in

fect

ion

to a

sses

s cl

inic

al

sign

s. S

imul

tane

ousl

y, w

ith

the

exce

ptio

n of

day

s 1

and

2, q

uart

er m

ilk s

ampl

es fo

r la

bora

tory

exa

min

atio

ns

(bac

teri

olog

y, s

omat

ic c

ell c

ount

) wer

e co

llect

ed to

as

sess

bac

teri

olog

ical

and

cyt

olog

ical

cur

e ra

tes.

Wer

ner

C, S

obir

aj A

, Sun

drum

A (2

010)

. Effi

cacy

of

hom

eopa

thic

and

ant

ibio

tic

trea

tmen

t str

ateg

ies

in c

ases

of

mild

and

mod

erat

e bo

vine

clin

ical

mas

titi

s. Jo

urna

l of

Dai

ry R

esea

rch,

77:

460

-467

.

On

days

28

and

56, t

reat

men

t str

ateg

ies

did

not d

iffe

r si

gnifi

cant

ly w

ith

resp

ect t

o th

e cl

inic

al o

utco

mes

and

the

tota

l cu

re r

ate

in c

ases

of b

acte

riol

ogic

al n

egat

ive

mas

titi

s (n

=56

). In

ca

ses

of p

atho

gen-

posi

tive

mas

titi

s (n

=91

), th

e cu

re r

ate

afte

r 4

and

8 w

eeks

was

sim

ilar

betw

een

the

two

trea

tmen

t str

ateg

ies,

ho

meo

path

y an

d an

tibi

otic

trea

tmen

t, b

ut th

e di

ffer

ence

be

twee

n th

e ho

meo

path

ic a

nd th

e pl

aceb

o tr

eatm

ent a

t day

56

was

sig

nifi

cant

(P<

0.05

). T

he r

esul

ts in

dica

te a

ther

apeu

tic

effe

ct o

f hom

eopa

thic

trea

tmen

t in

case

s of

mild

and

mod

erat

e cl

inic

al m

asti

tis.

Prel

imin

ary

24

A fi

eld

tria

l wit

h 10

2 da

iry

cow

s fr

om 1

3 Sw

iss

orga

nic

dair

y fa

rms

was

con

duct

ed. C

ows

wer

e ra

ndom

ly

assi

gned

to o

ne o

f thr

ee g

roup

s w

ithi

n a

herd

. In

the

Inte

rnal

Tea

t Sea

ler

grou

p (I

TS;

36

cow

s) c

ows

wer

e tr

eate

d w

ith

the

com

mer

cial

OR

BES

EAL

(Pfi

zer)

in

all f

our

quar

ters

imm

edia

tely

aft

er th

e la

st m

ilkin

g.

In th

e ho

meo

path

y gr

oup

(HD

T; 3

2 co

ws)

the

cow

s w

ere

trea

ted

per-

oral

ly b

y a

herd

-spe

cifi

c ho

meo

path

ic

form

ulat

ion

cons

isti

ng o

f tw

o re

med

ies

in 1

:10(

6)

dilu

tion

ove

r 5

days

bef

ore

and

afte

r dr

ying

-off

. The

un

trea

ted

grou

p re

ceiv

ed n

o th

erap

y (U

; 34

cow

s).

Klo

cke

P, Iv

emey

er S

, But

ler

G, M

aesc

hli A

, Hei

l F

(201

0). A

ran

dom

ized

con

trol

led

tria

l to

com

pare

the

use

of h

omeo

path

y an

d in

tern

al T

eat S

eale

rs fo

r th

e pr

even

tion

of m

asti

tis

in o

rgan

ical

ly fa

rmed

dai

ry

cow

s du

ring

the

dry

peri

od a

nd 1

00 d

ays

post

-cal

ving

. H

omeo

path

y, 9

9: 9

0-98

.

For

ITS,

HD

T a

nd U

the

clin

ical

mas

titi

s in

cide

nce

rate

s fo

r th

e fi

rst 1

00 d

ays

post

-cal

ving

wer

e 11

%, 9

% a

nd 3

%, r

espe

ctiv

ely,

an

d th

e pr

opor

tion

of n

orm

ally

sec

reti

ng q

uart

ers

was

(qua

rter

so

mat

ic c

ell c

ount

(SC

C) [

QSC

C]<

100,

000/

ml)

70%

, 68%

, and

65

%, r

espe

ctiv

ely.

Pow

er a

naly

sis

indi

cate

s th

at a

pro

port

ion

of

75%

wou

ld s

uppo

rt th

e re

ject

ion

of n

ull h

ypot

hesi

s in

the

HD

T,

and

74%

in th

e IT

S gr

oup

agai

nst u

ntre

ated

con

trol

. Qua

rter

s of

co

ws

wit

h SC

C<

200,

000/

ml a

t dry

ing-

off s

how

ed s

igni

fica

ntly

hi

gher

nor

mal

sec

reti

on in

HD

T g

roup

(odd

s ra

tio

[OR

] 9.

69)

com

pare

d to

unt

reat

ed c

ontr

ol, w

here

as T

eat S

ealin

g le

ad to

an

OR

of 3

.09

(not

sig

nifi

cant

, pos

t hoc

pow

er 3

1.3%

).

Und

er th

e st

udie

d co

ndit

ions

her

d-sp

ecifi

c ho

meo

path

ic d

ry

cow

ther

apy

was

eff

ecti

ve in

incr

easi

ng th

e nu

mbe

r of

ani

mal

s w

ith

norm

al m

ilk s

ecre

tion

aft

er s

ubse

quen

t par

turi

tion

, co

mpa

red

to u

ntre

ated

con

trol

. It m

ay b

e an

eff

ecti

ve a

lter

nati

ve

to T

eat S

ealin

g, p

arti

cula

rly

in a

nim

als

wit

h re

lati

vely

low

SC

Cs.

Prel

imin

ary

Ran

dom

ized

con

trol

led

tria

l in

whi

ch n

ewbo

rn p

igle

ts

wer

e di

vide

d in

to 4

gro

ups

(n=

11

or 1

2): 1

) con

trol

, su

bjec

ted

to a

ntib

ioti

c tr

eatm

ent a

gain

st d

iarr

hea;

2)

hom

eopa

thic

Pho

spho

rus

30C

H a

ccor

ding

to th

e sy

mpt

oms

colle

cted

; 3) h

omeo

path

ical

ly p

repa

red

Esch

eric

hia

coli

30C

H p

repa

red

from

the

loca

lly

obta

ined

bac

teri

a; 4

) a c

ombi

nati

on o

f Pho

spho

rus

30C

H a

nd E

sche

rich

ia c

oli 3

0CH

.

Coe

lho

C d

e P,

Sot

o FR

M e

t al.

(200

9). E

valu

atio

n of

pr

even

tive

hom

eopa

thic

trea

tmen

t aga

inst

col

ibac

illos

is

in s

win

e pr

oduc

tion

. Int

erna

tiona

l Jou

rnal

of H

igh

Dilu

tion

Res

earc

h, 8

: 183

-190

.

Gro

up 2

, 3 a

nd 4

pre

sent

ed a

sig

nifi

cant

red

ucti

on o

f dia

rrhe

a co

mpa

red

to th

e co

ntro

l gro

up (p

=0.

02);

the

grou

p tr

eate

d w

ith

Phos

phor

us 3

0CH

+ E

sche

rich

ia c

oli 3

0CH

pre

sent

ed th

e hi

ghes

t wei

ght g

ain

whi

ch w

as s

igni

fica

nt b

y co

mpa

riso

n to

all

othe

r gr

oups

(p=

0.00

1).

Prel

imin

ary

Ran

dom

ised

, obs

erve

r bl

ind,

pla

cebo

-con

trol

led

clin

ical

tr

ial.

On

a co

mm

erci

al p

ig fa

rm 5

2 so

ws

of d

iffe

rent

pa

riti

es, i

n th

eir

last

mon

th o

f ges

tati

on, w

ere

trea

ted

twic

e a

wee

k w

ith

eith

er th

e ho

meo

path

ical

ly p

repa

red

Esch

eric

hia

Col

i 30K

or

plac

ebo.

The

525

pig

lets

bo

rn fr

om th

ese

sow

s w

ere

scor

ed fo

r oc

curr

ence

and

du

rati

on o

f dia

rrho

ea.

Cam

erlin

k I,

Elli

nger

L e

t al (

2010

). H

omeo

path

y as

re

plac

emen

t to

anti

biot

ics

in th

e ca

se o

f Esc

heri

chia

col

i di

arrh

oea

in n

eona

tal p

igle

ts. H

omeo

path

y, 9

9: 5

7–62

.

Pigl

ets

of th

e ho

meo

path

ic tr

eate

d gr

oup

had

sign

ifica

ntly

less

E.

col

i dia

rrho

ea th

an p

igle

ts in

the

plac

ebo

grou

p (p

< 0

.000

1).

Espe

cial

ly p

igle

ts fr

om fi

rst p

arit

y so

ws

gave

a g

ood

resp

onse

to

trea

tmen

t wit

h Es

cher

ichi

a C

oli 3

0K. T

he d

iarr

hoea

see

med

to

be le

ss s

ever

e in

the

hom

eopa

thic

ally

trea

ted

litte

rs, t

here

was

le

ss tr

ansm

issi

on a

nd d

urat

ion

appe

ared

sho

rter

.

Stro

ng

25

26

Ref

eren

ces

1. Hu, J., Zhang, J., Zhao, W., Zhang, Y. Shang, H (2011). Cochrane systematic reviews of Chinese herb-

al medicines: an overview. PloS one 6, e28696.

2. Gibbs, R (2013). Evaluating the Biological Actions of Chinese Medicinal Herbs. Register of Chinese

Herbal Medicine Journal, 10: 31–38.

3. Teucher, B., Olivares, M. Cori, H (2004). Enhancers of iron absorption: Ascorbic acid and other

organic acids. International journal for vitamin and nutrition research, 74: 403–419.

4. Bishayee A, Thoppil RJ, Waghray A, Kruse JA, Novotny NA, Darvesh AS (2012). Dietary phytochemi-

cals in the chemoprevention and treatment of hepatocellular carcinoma: in vivo evidence, molecular

targets, and clinical relevance. Current Cancer Drug Targets. 12(9):1191-1232.

5. Ricciardiello L, Bazzoli F, Fogliano V (2011). Phytochemicals and colorectal cancer prevention-myth

or reality? Nature reviews. Gastroenterology & hepatology, 8(10):592-596.

6. Fiebich BL, Knörle R, Appel K, Kammler T, Weiss G (2011). Pharmacological studies in an herbal

drug combination of St. John’s Wort (Hypericum perforatum) and passion flower (Passiflora incarnata):

in vitro and in vivo evidence of synergy between Hypericum and Passiflora in antidepressant

pharmacological models. Fitoterapia. 82(3):474-480.

7. Gertsch J (2011). Botanical drugs, synergy, and network pharmacology: forth and back to intelligent

mixtures. Planta Medica,77(11):1086-1098. doi: 10.1055/s-0030-1270904.

8. Hemaiswarya S, Kruthiventi AK, Doble M (2008). Synergism between natural products and antibiot-

ics against infectious diseases. Phytomedicine, 15(8):639-652.

9. Wagner H, Ulrich-Merzenich G (2009). Synergy research: approaching a new generation of

phytopharmaceuticals. Phytomedicine, 16(2-3):97-110. Review part 1.

10. Ibid.

11. Chan BC, Ip M, Lau CB, Lui SL, Jolivalt C, Ganem-Elbaz C, Litaudon M, Reiner NE, Gong H, See RH,

Fung KP, Leung PC (2011). Synergistic effects of baicalein with ciprofloxacin against NorA over-

expressed methicillin-resistant Staphylococcus aureus (MRSA) and inhibition of MRSA pyruvate kinase.

Journal of Ethnopharmacology, 137(1):767-773.

12. Kourtesi C, Ball AR, Huang Y, Jachak SM, Vera DMA, Khondkar P, Gibbons S, Hamblin MR, Tegos GP.

(2013). Drug Discovery and the Challenge of Clinical Implementation. Open Microbiology Journal, 7,

(S: 1M3 ) 34-52.

13. Zuo GY, Zhang XY, Yang CX, Han J, Wang GC, Bian ZQ (2012a). Evaluation of traditional Chinese

medicinal plants for anti-MRSA activity with reference to the treatment record of infectious diseases.

Molecules, 17: 2955-2967.

14. Klancnik A, Možina SS, Zhang Q (2012). Anti-Campylobacter activities and resistance mechanisms of

natural phenolic compounds in Campylobacter. PLoS One, 7(12).

15. Kurincic M, Klancnik A, Smole Možina S (2012). Effects of efflux pump inhibitors on erythromycin,

ciprofloxacin, and tetracycline resistance in Campylobacter spp. isolates. Microbial Drug Resistance.

18(5):492-501.

16. Zuo GY, Li Y, Han J, Wang GC, Zhang YL, Bian ZQ (2012). Antibacterial and synergy of berberines with

antibacterial agents against clinical multi-drug resistant Isolates of methicillin-resistant Staphylococ-

cus aureus (MRSA). Molecules, 17(9), 10322-10330.

17. Chan BC, Ip M, Lau CB, Lui SL, Jolivalt C, Ganem-Elbaz C, Litaudon M, Reiner NE, Gong H, See RH,

Fung KP, Leung PC. (2011). Synergistic effects of baicalein with ciprofloxacin against NorA

over-expressed methicillin-resistant Staphylococcus aureus (MRSA) and inhibition of MRSA pyruvate

kinase. Journal of Ethnopharmacology, 137(1):767-773.

27

Ref

eren

ces

18. Ponnusamy K, Ramasamy M, Savarimuthu L, Paulraj MG (2010). Indirubin potentiates ciprofloxacin

activity in the NorA efflux pump of Staphylococcus aureus. Scandinavian Journal of Infectious Diseases.

42, (6-7):500-505.

19. Zuo GY, Wanga GC, Zhao YB, Xua GL, Haob XY, Hanc J, Zhao Q (2008). Screening of Chinese me-

dicinal plants for inhibition against clinical isolates of methicillin-resistant Staphylococcus aureus

(MRSA). Ethnopharmacology, 120, (2): 287–290.

20. Zuo GY, Zhang XY, Yang CX, Han J, Wang GC, Bian ZQ (2012a). Evaluation of traditional Chinese

medicinal plants for anti-MRSA Activity with reference to the treatment record of infectious diseases.

Molecules, 17: 2955-2967.

21. Hubbert M, Sievers H, Lehnfeld R, Kehrl W (2006). Efficacy and tolerability of a spray with Salvia of-

ficinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study

with adaptive design and interim analysis. European Journal of Medical Research, 11(1):20-26.

22. Schapowal A, Berger D, Klein P, Suter A (2009). Echinacea/sage or chlorhexidine/lidocaine for treat-

ing acute sore throats: a randomized double-blind trial. European Journal of Medical Research,

14(9):406-412.

23. Yang ZC, Wang BC, Yang XS, Wang Q, Ran L (2005). The synergistic activity of antibiotics combined

with eight traditional Chinese medicines against two different strains of Staphylococcus aureus.

Colloids and surfaces. B, Biointerfaces, 41(2-3):79-81.

24. Sharma SM, Anderson M, Schoop SR, Hudson JB (2010). Bactericidal and anti-inflammatory proper-

ties of a standardized Echinacea extract (Echinaforce): dual actions against respiratory bacteria.

Phytomedicine. 17(8-9):563-568.

25. Hubbert M, Sievers H, Lehnfeld R, Kehrl W (2006). Efficacy and tolerability of a spray with Salvia of-

ficinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study

with adaptive design and interim analysis. European Journal of Medical Research, 11(1):20-26.

26. Watkins F, Pendry B, Sanchez-Medina A, Corcoran O (2012). Antimicrobial assays of three native

British plants used in Anglo-Saxon medicine for wound healing formulations in 10th century

England. Journal of Ethnopharmacology, 144(2):408-415.

27. Chan YS, Cheng LN, Wu JH, Chan E, Kwan YW, Lee SM, Leung GP, Yu PH, Chan SW (2011). A review

of the pharmacological effects of Arctium lappa (burdock). Inflammopharmacology, 19(5):245-254.

28. Yarnell E (2002). Botanical medicines for the urinary tract. World J Urol, 20(5):285-293.

29. European Medicines Agency (2012). Assessment report on Arctostaphylos uva-ursi (L.) Spreng.,

folium, EMA/HMPC/573462/2009 Rev.1 (HMPC).

30. Larsson, B., Jonasson, A., & Fianu, S (1993). Prophylactic effect of UVA-E in women with recurrent

cystitis: A preliminary report. Current Therapeutic Research, 53(4), 441-443.

31. Siegers, C., Bodinet, C., Ali, S., & Siegers, C (2003). Bacterial deconjugation of arbutin by

Escherichia coli. Phytomedicine, 10(4), 58-60.

32. Rafsanjany N, Lechtenberg M, Petereit F, Hensel A (2013). Antiadhesion as a functional concept for

protection against uropathogenic Escherichia coli: in vitro studies with traditionally used plants with

antiadhesive activity against uropathognic Escherichia coli. Journal of Ethnopharmacology,

145(2):591-597.

33. Kumar VP, Chauhan NS, Padh H, Rajani M (2006). Search for antibacterial and antifungal agents from

selected Indian medicinal plants. Journal of Ethnopharmacology, 107(2):182-188

34. Srinivasan D, Nathan S, Suresh T, Lakshmana Perumalsamy P (2001). Antimicrobial activity of cer-

tain Indian medicinal plants used in folkloric medicine. Journal of Ethnopharmacology, 74(3):217-20.

35. Selvam NT, Chandran KS, Rani KU, Saraswathy VN, Venugopalan TN, Pankajavally PT, Kumar YR,

Jaya N (2008).Comparative study on efficacy of Antimicrobial activity of three Ayurvedic drugs

Balaguduchi, Dhanadanayanadi and Dasamoolabala on isolated Nosocomial Pathogens.

Ancient Science of Life, 28(2):19-25.

28

36. Murthy MM, Subramanyam M, Giridhar KV, Jetty A (2006). Antimicrobial activities of bharangin

from Premna herbaceae Roxb. and bharangin monoacetate. Journal of Ethnopharmacology,

104(1-2):290-292

37. Li Y, He Y, Sheng Y, Wang K, Wang J, Huang J, Yang J, Zheng Q (2013).Systematic evaluation of

noninferiority and equivalence randomized trials of anti-infective drugs.

Expert review of anti-infective therapy, 11(12):1377-89.

38. Ulbricht C, Abrams TR, Conquer J, Costa D, Serrano JM, Iovin R, Isaac R, Nguyen Y, Rusie E, Tran D,

Weissner W, Windsor RC (2010). An evidence-based systematic review of umckaloabo

(Pelargonium sidoides) by the Natural Standard Research Collaboration. Journal of Dietary Supplements,

7(3):283-302.

39. Fintelmann V, Albrecht U, Schmitz G, Schnitker J (2012). Efficacy and safety of a combination herbal

medicinal product containing nasturtium (Tropaeoli majoris herba) and Horseradish (Armoracia

rusticana) for the prophylactic treatment of patients with respiratory tract diseases: a randomised,

prospective, double-blind, placebo-controlled phase III trial. Current Medical Research Opinion;

28(11):1799-1807.

40. Ibid.

41. Puram S, Suh, Seung HC, Kim U, et al. (2013). Effect of GutGard in the Management of Helicobacter

pylori: A Randomized Double Blind Placebo Controlled Study, Evidence-Based Complementary and

Alternative Medicine, Article ID 263805, 8 pages, doi:10.1155/2013/263805.

42. Ibid.

43. Albrecht U, Goos KH, Schneider B (2007). A randomised, double-blind, placebo-controlled trial

of a herbal medicinal product containing Tropaeoli majoris herba (Nasturtium) and Armoraciae

rusticanae radix (Horseradish) for the prophylactic treatment of patients with chronically recurrent

lower urinary tract infections. Current Medical Research Opinion, 23(10):2415-2422.

44. Ibid.

45. Huang MJ (2007). A randomised control trial of a complex Chinese herbal medicine (San Ling Jie

Du Tang) in the treatment of women with recurrent lower urinary tract infections (RUTIs).

Hubei Journal of Traditional Chinese Medicine, 29:38-39.

46. Ibid.

47. Huang Y, Wu T, Zeng , Li S (2012). A Cochrane systematic review of Chinese herbs for sore throat,

Cochrane Database Systematic Review. 14;3:CD004877.

48. Ibid.

49. Salem EM, Yar T, Bamosa AO, Al-Quorain A, Yasawy MI, Alsulaiman RM, Randhawa MA(2010).

Comparative study of Nigella sativa and triple therapy in eradication of Helicobacter pylori in patients

with non-ulcer dyspepsia. Saudi Journal of Gastroenterology, 16(3):207-214.

50. Ibid.

51. Bornhöft G, Wolf U, et al. (2006). Effectiveness, safety and cost-effectiveness of homeopathy in

general practice–summarized health technology assessment. Forschende Komplementärmedizin,

13 Suppl 2: 19-29.

52. Dantas F, Rampes H (2000). Do homeopathic medicines provoke adverse effects?

A systematic review. British Homeopathic Journal, 89 Suppl 1:S35-38.

53. Grabia S, Ernst E (2003). Homeopathic aggravations: a systematic review of randomised,

placebo- controlled clinical trials. Homeopathy, 92(2):92-98.

54. Woodward KN (2005). The potential impact of the use of homeopathic and herbal remedies on

monitoring the safety of prescription products. Human & Experimental Toxicology, 24:219-233.

55. Jacobs J, Springer DA, Crothers D (2001). Homeopathic treatment of acute otitis media in children:

a preliminary randomized placebo-controlled trial. Pediatric Infectious Disease Journal, 20:177-183

29

56. Taylor JA, Jacobs J (2011). Homeopathic ear drops as an adjunct to standard therapy in children with

acute otitis media. Homeopathy, 100(3):109-115

57. Sinha MN, Siddiqui VA, Nayak C, Singh V, Dixit R, Dewan D, Mishra A (2012). Randomized con-

trolled pilot study to compare homeopathy and conventional therapy in acute otitis media.

Homeopathy; 101: 5-12.

58. Friese K-H, Zabalotnyi DI (2007). [Homeopathy in acute rhinosinusitis. A double-blind, placebo

controlled study shows the effectiveness and tolerability of a homeopathic combination remedy].

HNO, 55: 271-277.

59. Zabolotnyi DI, Kneis KC, Richardson A et al (2007). Efficacy of a complex homeopathic medication

(Sinfrontal) in patients with acute maxillary sinusitis: a prospective, randomized, double-blind,

placebo-controlled, multicentre clinical trial. Explore (NY), 3: 98-109.

60. Weiser M, Clasen B (1994). [Randomised, placebo-controlled, double-blind study of the clinical

efficacy of the homeopathic Euphorbium compositum-S nasal spray in cases of chronic sinusitis].

Forschende Komplementärmedizin, 1:251-259.

61. Wiesenauer M, Gaus W, Bohnacker U, Häussler S (1989). Wirksamkeitsprüfung von homöopathis-

che Kombinationspräparaten bei Sinusitis. Ergebnisse einer randomisierten Doppelblindstudie

unter Praxisbedingungen [Efficiency of homeopathic preparation combinations in sinusitis. Results

of a randomized double blind study with general practitioners]. Arzneimittel Forschung, 39:620–625.

62. Gassinger CA, Wünstel G, Netter P (1981). Klinische Prüfung zum Nachweis der therapeutischen

Wirksamkeit des homöopathischen Arzneimittels Eupatorium perfoliatum D2 (Wasserhanf com-

posite) bei der Diagnose “Grippaler Infekt”. [A controlled clinical trial for testing the efficacy of

the homeopathic drug Eupatorium perfoliatum D2 in the treatment of common cold]. Arzneimittel

Forschung, 31:732–736.

63. Maiwald VL, Weinfurtner T, et al (1988). [Treatment of common cold with a combination homeo-

pathic preparation compared with acetylsalicylic acid. A controlled, randomized single-blind study].

Arzneimittel Forschung, 38:578-582

64. Brydak LB, Denys A (1999). The evaluation of humoral response and the clinical evaluation of a risk-

group patients’ state of health after administration of the homeopathic preparation Gripp-Heel

during the influenza epidemic season 1993 to 94. International Review of Allergology and Clinical

Immunology, 5:223-227.

65. Ferley JP, Zmirou D et al (1989). A controlled evaluation of a homeopathic preparation in the

treatment of influenza like syndromes. British Journal of Clinical Pharmacology, 27:329-335

66. Papp, R, Schuback G, et al (1998). Oscillococcinum® in patients with influenza-like syndromes:

a placebo-controlled double-blind evaluation. British Homeopathic Journal, 87:69-76.

67. Chakraborty PS, Lamba CD, Nayak D, John MD, Sarkar DB, Poddar A, Arya JS, Raju K, Vivekanand K,

Singh HBK, Baig H, Prusty AK, Singh V, Nayak C (2013). Effect of individualized homoeopathic

treatment in influenza like illness: A multicenter, single blind, randomized, placebo controlled

study. Indian Journal of Research in Homoeopathy, 7: 22-30.

68. Bornhöft G, Matthiessen PF (eds)(2001). Homeopathy in Healthcare – Effectiveness, Appropriate-

ness, Safety, Costs. An HTA report on homeopathy as part of the Swiss Complementary Medicine

Evaluation Programme. Springer Verlag Berlin ISBN-13 978-3-642-20638-2, page 145.

69. de Lange de Klerk ESM, Blommers J, Kuik DJ, Bezemer PD, Feenstra L (1994). Effects of homoeo-

pathic medicines on daily burden of symptoms in children with recurrent upper respiratory tract

infections. British Medical Journal, 309:1329–1332.

30

70. Steinsbekk A, Bentzen N, Fønnebø V, Lewith G (2005). Self-treatment with one of three self selected,

ultramolecular homeopathic medicines for the prevention of upper respiratory tract infections in

children. A double-blind randomized placebo controlled trial. British Journal of Clinical Pharmacology,

59:447–455.

71. Steinsbekk A, Fønnebø V, Lewith G, Bentzen N (2005). Homeopathic care for the prevention of upper

respiratory tract infections in children: a pragmatic, randomized, controlled trial comparing rand-

omized homeopathic care and waiting-list controls. Complementary Therapies in Medicine, 13:231–238.

72. Hamre HJ, Fischer M et al. (2005). Anthroposophic vs. conventional therapy of acute respiratory and

ear infections: a prospective outcomes study. Wiener klinische Wochenschrift, 117: 256–268

73. Jeschke E, Lüke C et al. (2007). Verordnungsverhalten anthroposophisch orientierter Ärzte bei

akuten Infektionen der oberen Atemwege [Prescribing practices in the treatment of upper respira-

tory tract infections in anthroposophic medicine]. Forschende Komplementärmedizin, 14: 207-215.

74. Geyer U, Diederich K, Kusserow M, Laubersheimer A, Kramer K (2013). Inpatient treatment of

community-acquired pneumonias with integrative medicine. Evidence Based Complementary

Alternative Medicine, 2013: 578274.

75. Hamre HJ, Fischer M et al. (2007). Use and Safety of Anthroposophic Medications for Acute

Respiratory and Ear Infections: A Prospective Cohort Study. Drug Target Insights, 2: 209–219.

76. Andersson R, Morcillo LL, Sommer H (1997). Untersuchungen über den Einsatz von homöopathis-

chen Arzneimitteln bei der Behandlung und Prophylaxe subklinischer Mastitiden von Milchkühen

[Treatment and prophylaxis of subclinical mastitis with homeopathic drugs]. Tierärztliche Umschau,

52: 407–412.

77. Searcy R, Reyes O, Guajardo G (1995). Control of subclinical bovine mastitis. Utilization of a

homoeopathic combination. British Homeopathic Journal, 84: 67-70.

78. Varshney JP, Naresh R (2005). Comparative efficacy of homeopathic and allopathic systems of

medicine in the management of clinical mastitis of Indian dairy cows. Homeopathy, 94: 81-85.

79. Werner C, Sobiraj A, Sundrum A (2010). Efficacy of homeopathic and antibiotic treatment strategies

in cases of mild and moderate bovine clinical mastitis. Journal of Dairy Research, 77: 460-467.

80. Klocke P, Ivemeyer S, Butler G, Maeschli A, Heil F (2010). A randomized controlled trial to compare

the use of homeopathy and internal Teat Sealers for the prevention of mastitis in organically farmed

dairy cows during the dry period and 100 days post-calving. Homeopathy, 99: 90-98.

81. Coelho C de P, Soto FRM, et al. (2009). Evaluation of preventive homeopathic treatment against

colibacillosis in swine production. International Journal of High Dilution Research, 8: 183-190.

82. Camerlink I, Ellinger L, et al (2010). Homeopathy as replacement to antibiotics in the case of

Escherichia coli diarrhoea in neonatal piglets. Homeopathy, 99: 57–62.

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