The (In)Effectiveness of Homeopathic Remedies in Treating Respiratory Infections

This review aimed to evaluate the effectiveness of homeopathic treatments for respiratory infections, particularly upper respiratory tract infections (URTIs) like pharyngitis caused by Streptococcus pyogenes. It seeks to determine how well homeopathy can alleviate symptoms, reduce the duration of the illness, decrease the need for antibiotics, and improve overall patient outcomes.

To evaluate the effectiveness of homeopathy in treating respiratory infections, the review incorporated observational studies, randomized controlled trials (RCTs), systematic reviews, and in vitro research. Relevant studies were identified through searches in databases like Google Scholar, PubMed, AYUSH, and various homeopathic journals. The research considered included evaluations of homeopathy alone or alongside conventional treatments for upper respiratory tract infections (URTIs) in both children and adults. Studies with small sample sizes, incomplete data, duplicates, or content that could not be retrieved were excluded to ensure reliability.

The findings suggest that Atropa Belladonna 12C and other homeopathic remedies exhibit antibacterial effects against Streptococcus pyogenes in laboratory settings. Clinical studies indicate that homeopathy may help reduce fever, lessen symptom severity, and decrease the need for antibiotics in cases of upper respiratory infections (URTIs). For instance, in a study focused on recurrent pharyngitis, 93.33% of patients treated with homeopathy reported improvement, compared to only 33.34% in the biochemic group. Additionally, the EPI3 Cohort Study revealed a reduction in antibiotic use, although it did not show significant differences in the progression of the disease, according to some systematic reviews. While homeopathy appears to hold promise, further research is necessary to confirm its long-term effectiveness.

The authors conculded that research suggests that homoeopathy could serve as a helpful complementary treatment for respiratory infections, potentially reducing the reliance on antibiotics and enhancing symptom relief. However, further comprehensive studies are necessary to confirm its effectiveness and establish standardized treatment protocols. Integrating homeopathy into public health strategies may offer an additional approach to managing respiratory infections in both children and adults.

This review is a perfect model for people who want to know how NOT to conduct a meaningful review:

1. Its aim is diffuse.
2. Its methodology is vague.
3. It includes anything from in-vitro experiments to clinical trials.
4. It does not have a ‘results’ section but provides details of the primary studies in the ‘discussion’ section.
5. It does not even attempt to evaluate the methodological quality of the primary studies which, in most cases, is dismal.
6. It draws conclusions that are not based on sound data.

What emerges, once one has managed to obtain a clear picture of the carefully obfuscated evidence, is quite simple: there are no reliable studies to show that homeopathy is effective in treating respiratory infections. In view of this, I need to correct the conclusions of this review as follows:

Research shows that homeopathy as a treatment of respiratory infections is not supported by the evidence of reliable clinical trials. Its use should therefore be discouraged.

This, by the way, would also be more in line with the Cochrane review on the subject:

Background: Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs annually. Although most infections are self-limiting, symptoms can be distressing. Many treatments are used to control symptoms and shorten illness duration. Most treatments have minimal benefit and may lead to adverse events. Oral homeopathic medicinal products could play a role in childhood ARTI management if evidence for their effectiveness is established. This is an update of a review first published in 2018.

Objectives: To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat ARTIs in children.

Search methods: We searched CENTRAL (2022, Issue 3), including the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 16 March 2022), Embase (2010 to 16 March 2022), CINAHL (1981 to 16 March 2022), AMED (1985 to 16 March 2022), CAMbase (searched 16 March 2022), and British Homeopathic Library (searched 26 June 2013 – no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov (16 March 2022), checked references, and contacted study authors to identify additional studies.

Selection criteria: We included double-blind randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self-selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years.

Data collection and analysis: We used standard methodological procedures expected by Cochrane.

Main results: In this 2022 update, we identified three new RCTs involving 251 children, for a total of 11 included RCTs with 1813 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for ARTIs. All studies focused on upper respiratory tract infections (URTIs), with only one study including some lower respiratory tract infections (LRTIs). Six treatment studies examined the effect on URTI recovery, and five studies investigated the effect on preventing URTIs after one to four months of treatment. Two treatment and three prevention studies involved homeopaths individualising treatment. The other studies used predetermined, non-individualised treatments. All studies involved highly diluted homeopathic medicinal products, with dilutions ranging from 1 x 10^-4 to 1 x 10^-200. We identified several limitations to the included studies, in particular methodological inconsistencies and high attrition rates, failure to conduct intention-to-treat analysis, selective reporting, and apparent protocol deviations. We assessed three studies as at high risk of bias in at least one domain, and many studies had additional domains with unclear risk of bias. Four studies received funding from homeopathy manufacturers; one study support from a non-government organisation; two studies government support; one study was co-sponsored by a university; and three studies did not report funding support. Methodological inconsistencies and significant clinical and statistical heterogeneity precluded robust quantitative meta-analysis. Only four outcomes were common to more than one study and could be combined for analysis. Odds ratios (OR) were generally small with wide confidence intervals (CI), and the contributing studies found conflicting effects, so there was little certainty that the efficacy of the intervention could be ascertained. All studies assessed as at low risk of bias showed no benefit from oral homeopathic medicinal products, whilst trials at unclear or high risk of bias reported beneficial effects. For the comparison of individualised homeopathy versus placebo or usual care for the prevention of ARTIs, two trials reported on disease severity; due to heterogeneity the data were not combined, but neither study demonstrated a clinically significant difference. We combined data from two trials for the outcome need for antibiotics (OR 0.79, 95% CI 0.35 to 1.76; low-certainty evidence). For the comparison of non-individualised homeopathy versus placebo or usual care for the prevention of ARTIs, only the outcome recurrence of ARTI was reported by more than one trial; data from three studies were combined for this outcome (OR 0.60, 95% CI 0.21 to 1.72; low-certainty evidence). For the comparison of both individualised and non-individualised homeopathy versus placebo or usual care for the treatment of ARTIs, two studies provided data on short-term cure (OR 1.31, 95% CI 0.09 to 19.54) and long-term cure (OR 1.01, 95% CI 0.10 to 9.96; very low-certainty evidence). The studies demonstrated an opposite direction of effect for both outcomes. Six studies reported on disease severity but were not combined as they used different scoring systems and scales. Three studies reported adverse events (OR 0.79, 95% CI 0.16 to 4.03; low-certainty evidence).

Authors’ conclusions: Pooling of five prevention and six treatment studies did not show any consistent benefit of homeopathic medicinal products compared to placebo on ARTI recurrence or cure rates in children. We assessed the certainty of the evidence as low to very low for the majority of outcomes. We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children. Adverse events were poorly reported, and we could not draw conclusions regarding safety.

The moral of this long story might be this:

Cochrane reviews are more reliable than papers published in the International Journal on Science and Technology by homeopaths from the Department of Practice of Medicine, Bharati Vidyapeeth (Deemed to be University), and the Homoeopathic Medical College and Hospital, Pune- Satara Road, Maharashtra, India