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15 March 2005

Volume 40, Number 6
Clinical Infectious Diseases 2005;40:807–810
© 2005 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2005/4006-0005$15.00
DOI: 10.1086/428061
MAJOR ARTICLE

Treatment of the Common Cold with Echinacea: A Structured Review

Thomas J. Caruso1 and

Jack M. Gwaltney, Jr.2

1Stanford University School of Medicine, Stanford, CA; and 2Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville

Background.Echinacea is a herbal preparation that is frequently used to treat the common cold. Spending on echinacea in the United States has risen to >$300 million annually.

Methods.A total of 322 articles related to echinacea and colds, including 9 placebo‐controlled clinical trials, were identified using the Medline and PubMed databases. Eleven features of experimental design that affect the accuracy of the measurement of features of interest, the probability of a chance relationship, bias, and blinding were used to evaluate the 9 placebo‐controlled studies. The criteria were validated case definition, quantifiable hypothesis, sample‐size calculation, randomized assignment, double blinding, proof of blinding, measurement of compliance, measurement of drop‐out rate, analysis by intention to treat, description of the methods of analysis, and measurement of probability. Equal weight was given to each criterion, since failure to meet any one of them could potentially invalidate the findings of a clinical trial.

Results.Of the 9 studies, 2 met all 11 criteria. The results of both studies were judged to be negative by the people who performed the studies. Of the remaining 7 studies, 6 were judged to have positive results, and 1 was judged to have negative results. The criterion most commonly not met was proof of blinding.

Conclusions.This structured review suggests that the possible therapeutic effectiveness of echinacea in the treatment of colds has not been established.

Received 20 September 2004; accepted 28 October 2004; electronically published 18 February 2005.

  • (See the editorial commentary by Knight on pages 811–2)

Reprints or correspondence: Dr. Jack M. Gwaltney, Jr., Dept. of Internal Medicine, Box 800473, Charlottesville, VA 22908 ().

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P Larmo, J Alin, E Salminen, H Kallio, R Tahvonen. (2008) Effects of sea buckthorn berries on infections and inflammation: a double-blind, randomized, placebo-controlled trial. European Journal of Clinical Nutrition 62:9, 1123-1130
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Thomas J. Caruso, Charles G. Prober, and Jack M. Gwaltney, Jr.. (2007) Treatment of Naturally Acquired Common Colds with Zinc: A Structured Review. Clinical Infectious Diseases 45:5, 569-574
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David C. Nieman. (2006) Nutritional Strategies to Counter Stress to the Immune System. ACSM's Health & Fitness Journal 10:6, 15-20
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T. L. Charrois, J. Hrudey, S. Vohra. (2006) Echinacea. Pediatrics in Review 27:10, 385-387
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Vernon Knight. (2005) Editorial Commentary: Echinacea Treatment for the Common Cold. Clinical Infectious Diseases 40:6, 811-812
Online publication date: 15-Mar-2005.
Citation-Full Text-PDF Version (46 kB)
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