PHAR3817 Lecture 12: Evidence Based Medicine in Respiratory Disorders - URTI
22 Jul 2018
School
Department
Course
Professor
PHAR3817: Respiratory
60
Evidence%Based%Complementary%Medicine%in%Respiratory%Disorders%-%URTI%
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• Upper!respiratory!tract!infections!(URTIs),!often!referred!to!as!‘the!common!cold’!or!‘flu’,!can!be!caused!by!over!200!
different!viruses!including!rhinovirus,!corona!virus,!respiratory!syncytial!virus!or!influenza!
• Each!virus!can!present!slightly!differently,!with!common!symptoms!including!a!sore!or!‘scratchy’!throat,!nasal!congestion!
and!discharge,!sneezing,!headache!and!fatigue!
• Cough!is!experienced!by!93%!and!can!persist!for!at!least!two!weeks!in!58%!of!people!suffering!from!an!URTI!
• The!average!adult!experiences!2-4!infections!per!year!and!children!6-8!infections!per!year!
• Data!from!controlled!trials!of!cough!and!cold!medications!in!young!children!do!not!support!their!efficacy,!and!serious!side!
effects!have!been!reported!
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Pelargonium%
Pelargonium!(EPs7630)!is!a!TGA!registered!product!à!Kaloba!(Aust!R!193170)!
• Approved!for!the!treatment!of!acute!bronchitis,!acute!sinusitis!and!suitable!for!children!>2!
• Mucolytic!properties!
• Antibacterial!activity!identified!(appears!to!prevent!attachment!of!bacteria!to!the!mucous!membrane!cells)!
• May!have!immune-modulatory!properties!!
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Echinacea%purpurea%
Indication!for!use:!
• Treatment!of!URTI!(in!adults)!Level!B!-!Positive!scientific!evidence!
• Treatment!of!URTI!(children)!Level!C!-!Scientific!evidence!available,!but!unclear!and!conflicting!
• Prevention!of!URTI! ! Level!C!
• Immune!system!stimulation!! Level!C!
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Cochrane!review!summary!
• Evidence!for!acute!infection!rather!than!prevention!
• Improves!symptom!severity!and!rate!of!recovery!
• Greater!benefits!in!adults!than!children!
• Benefits!are!mainly!due!to!E.purpurea!root!with!
standardised!extracts!containing!alkylamides!
!
Adult!doses: !
• Dried!root:!1.5-4.5g/day!of!Echinacea!purpurea!
• Liquid!extract!(1:2)!3-9mL/day!
• The!dose!may!be!increased!to!10-20mL/day!in!acute!
conditions!
• Treatment!is!usually!started!at!the!first!sign!of!URTI!and!continued!for!7-14!days!
• Children!over!2!years!of!age!require!dosage!to!be!calculated!based!on!their!weight!and!age!
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