Bovine mastitis: are homeopathic remedies truly ‘as effective as antibiotics’?

Mastitis is a common disease in dairies. Numerous non-antimicrobial drugs and treatment strategies have been recommended for this condition. Homeopaths in particular have long claimed that their highly diluted remedies are an effective option, and I have reported repeatedly about the evidence – see here, here, and here, for instance. Even though it is far from positive, evangelic homeopaths like our friend Dana Ullman or naïve quackery-fans like Prince Charles claim that it is “as effective as antibiotics, the mastitis treatment of choice”.

So, who is right?

I am biased, homeopaths insist.

Ullman is a joke, any rational thinker must admit.

Prince Charles? … no comment.

What we need is an independent body to look at the data.

A new systematic review did exactly that. Its authors are highly respected and come from institutions that are not likely to promote bogus claims:

• Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Canada
• Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Canada
• Canadian Bovine Mastitis and Milk Quality Research Network, Canada
• Canadian Bovine Mastitis and Milk Quality Research Network, Canada
• Sherbrooke Research and Development Centre, Agriculture and Agri-Food Canada
• Canadian Bovine Mastitis and Milk Quality Research Network, Canada
• Département de Pathologie et Microbiologie, Faculté de Médecine Vétérinaire, Université de Montreal, Canada.

It was performed with studies written in English or French selected from CAB Abstracts, PubMed, and Web of Science. All treatments other than conventional antimicrobials for clinical mastitis during lactation were retained. Only studies comparing the treatment under investigation to a negative or positive control, or both, were included. Outcomes evaluated were clinical and bacteriological cure rates and milk production. Selection of the study, data extraction, and assessment of risk of bias was performed by 3 reviewers. Assessment of risk of bias was evaluated using the Cochrane Collaboration tool for systematic review of interventions.

A total of 2,451 manuscripts were first identified and 39 manuscripts corresponding to 41 studies were included. Among these, 22 were clinical trials, 18 were experimental studies, and one was an observational study. The treatments evaluated were conventional anti-inflammatory drugs (n = 14), oxytocin with or without frequent milk out (n = 5), biologics (n = 9), homeopathy (n = 5), botanicals (n = 4), probiotics (n = 2), and other alternative products (n = 2). All trials had at least one unclear or high risk of bias. Most trials (n = 13) did not observe significant differences in clinical or bacteriological cure rates in comparison with negative or positive controls. Few studies evaluated the effect of treatment on milk yield. In general, the power of the different studies was very low, thus precluding conclusions on non-inferiority or non-superiority of the treatments investigated. No evidence-based recommendations could be given for the use of an alternative or non-antimicrobial conventional treatment for clinical mastitis.

The authors concluded that homeopathic treatments are not efficient for management of clinical mastitis.

Will this finally stop homeopaths from claiming that their placebos work for mastitis?

I would not count on it!