{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:24:13Z","timestamp":1787916253788,"version":"build-2784847793"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T00:00:00Z","timestamp":1617840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"A.Vogel AG, Switzerland"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Med Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In children, up to 30% of viral respiratory tract infections (RTIs) develop into bacterial complications associated with pneumonia, sinusitis or otitis media to trigger a tremendous need for antibiotics. This study investigated the efficacy of <jats:italic>Echinacea<\/jats:italic> for the prevention of viral RTIs, for the prevention of secondary bacterial complications and for reducing rates of antibiotic prescriptions in children.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Echinaforce\u00ae Junior tablets [400\u00a0mg freshly harvested <jats:italic>Echinacea purpurea<\/jats:italic> alcoholic extract] or vitamin C [50\u00a0mg] as control were given three times daily for prevention to children 4\u201312\u00a0years. Two\u2009\u00d7\u20092\u00a0months of prevention were separated by a 1-week treatment break. Parents assessed respiratory symptoms in children via <jats:italic>e<\/jats:italic>-diaries and collected nasopharyngeal secretions for screening of respiratory pathogens (Allplex\u00ae RT-PCR).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, 429 cold days occurred in N<jats:sub>ITT<\/jats:sub>\u2009=\u2009103 children with <jats:italic>Echinacea<\/jats:italic> in comparison to 602\u00a0days in N<jats:sub>ITT<\/jats:sub>\u2009=\u200998 children with vitamin\u00a0C (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, Chi-square test). <jats:italic>Echinacea<\/jats:italic> prevented 32.5% of RTI episodes resulting in an odds ratio of OR\u2009=\u20090.52 [95% CI 0.30\u20130.91, <jats:italic>p<\/jats:italic>\u2009=\u20090.021]. Six children (5.8%) with <jats:italic>Echinacea<\/jats:italic> and 15 children (15.3%) with vitamin C required 6 and 24 courses of antibiotic treatment, respectively (reduction of 76.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). A total of 45 and 216\u00a0days of antibiotic therapy were reported in the two groups, respectively (reduction of 80.2% (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Eleven and 30 events of RTI complications (e.g., otitis media, sinusitis or pneumonia) occurred with <jats:italic>Echinacea<\/jats:italic> and vitamin C, respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.0030). <jats:italic>Echinacea<\/jats:italic> significantly prevented influenza (3 vs. 20 detections, <jats:italic>p<\/jats:italic>\u2009=\u20090.012) and enveloped virus infections (29 vs. 47 detections, <jats:italic>p<\/jats:italic>\u2009=\u20090.0038). Finally, 76 adverse events occurred with <jats:italic>Echinacea<\/jats:italic> and 105 events with vitamin C (<jats:italic>p<\/jats:italic>\u2009=\u20090.016), only three events were reported possibly related with <jats:italic>Echinacea<\/jats:italic>.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our results support the use of Echinacea for the prevention of RTIs and reduction of associated antibiotic usage in children.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic> clinicaltrials.gov, NCT02971384, 23th Nov 2016.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40001-021-00499-6","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T13:03:17Z","timestamp":1617886997000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial"],"prefix":"10.1186","volume":"26","author":[{"given":"Mercedes","family":"Ogal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian L.","family":"Johnston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Klein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0473-7697","authenticated-orcid":false,"given":"Roland","family":"Schoop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"issue":"1","key":"499_CR1","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/S0149-2918(02)85013-5","volume":"24","author":"R Cantrell","year":"2002","unstructured":"Cantrell R, Young AF, Martin BC. 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Parents and\/or children have given their informed consent prior to any trial-related intervention.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Participants have given their consent that data from this study can be published in an anonymized form.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MO and PK declare no conflict of interest. SLJ is a consultant to A. Vogel AG, Switzerland. Data evaluation was carried out by an independent provider of data management and statistical services (d.s.h. GmbH, Germany). RS is an employee at A. Vogel AG, Switzerland, who was however not involved in data collection or analysis.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"33"}}