Homeopathic preparations for preventing and treating acute upper respiratory tract infections in children: A systematic review and meta-analysis

BACKGROUND: Acute upper respiratory tract infections (ARTIs) are common and mostly self-limiting. A range of treatments are used with the aim to cure or treat symptoms, including widespread use of homeopathic treatments.

OBJECTIVES: To undertake a systematic review and meta-analysis of trials with the highest level of evidence, to establish the benefits and risks for oral homeopathic remedies used to treat and prevent ARTIs in children.

DATA SOURCES: MEDLINE, Embase, CINAHL, AMED, CAMbase, British Homeopathic Library, CENTRAL, WHO ICTRP and ClinicalTrials.gov registers to March 2018.

STUDY ELIGIBILITY, PARTICIPANTS, AND INTERVENTIONS: Double-blinded randomized trials in children, treated with oral homeopathic remedies versus placebo or conventional treatments for ARTI.

APPRAISAL AND SYNTHESIS METHODS: Studies were reviewed in duplicate for inclusion, data extraction and risk of bias. Meta-analysis was performed on only four outcomes. Other outcomes were reported narratively.

RESULTS: Eight studies (1562 children) were included. Four studies examined treatment and four prevention of ARTIs. Four studies involved homeopaths individualizing treatment versus four with non-individualized treatments. Three studies had high risk of bias in at least one domain. All studies with low risk of bias showed no benefit from homeopathy; trials at uncertain and high risk of bias reported beneficial effects. Two individualized treatment studies (N=155) did not show benefit on short-term or long-term cure. Prevention trials showed no significant outcomes: recurrence of ARTIs. No serious events were reported.

LIMITATIONS: Methodological inconsistencies and heterogeneity.

CONCLUSIONS: The effectiveness for homeopathic remedies for childhood ARTIs is not supported in higher quality trials.

SYSTEMATIC REVIEW REGISTRATION NUMBER: CD005974.