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FACT
Focus on Alternative and Complementary Therapies

Andrographis paniculata in the treatment and prevention of upper respiratory tract infection (URTI): a systematic review of safety and efficacy

Thompson Coon JS, Ernst E
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter, EX2 4NT, UK

Objective

Andrographis paniculata (AP) is used in the treatment of respiratory infection. Animal studies suggest anti-inflammatory, antipyretic and immunostimulatory properties. This review assesses the safety and efficacy of AP in the treatment and prevention of acute upper respiratory tract infection (URTI).

Materials and methods

Systematic literature searches were conducted in seven computerised databases to February 2002. Experts in the field and manufacturers were asked for published and unpublished data; information was requested from spontaneous reporting schemes of the WHO and national safety bodies. No language restrictions were imposed. Trials of monopreparations or combination preparations against placebo or reference treatment were included. Screening and selection of trials, data extraction and evaluation of methodological quality were performed independently by two reviewers.

Results

Seven trials met the inclusion criteria and scored at least three out of five points for methodological quality. Five trials (n = 803) reported the effects on patient-evaluated symptoms. Of these, three of AP alone (n = 317) and one of AP in combination with Eleutherococcus senticosus (ES) (n = 180) reported a significant improvement in favour of the AP preparation. One trial compared the effects of AP with paracetamol on the resolution of pharyngo-tonsillitis (n = 152); AP was equally effective. One trial showed a significant decrease in the rate of infections compared with placebo after 3 months. Adverse events were mild and infrequent.

Conclusion

The data suggest that AP alone or in combination with ES is superior to placebo in alleviating URTI symptoms. They also provide preliminary evidence of a preventative role; further research is warranted.

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