Homeopathic and conventional treatments for acute upper respiratory tract infections (aURTI): Real-World cohort study on recurrence and antibiotic prescriptions.

Introduction: The study evaluated the recurrence of acute upper respiratory tract infections (aURTI) and the number of antibiotic prescriptions within 12-month follow-up in patients prescribed with either homeopathic medicines or medicines from one of four conventional medication classes for aURTI therapy.

Methods: This explorative cohort study used real-world electronic healthcare data from the Disease Analyzer database (IQVIA). Included were patients of all ages from Germany with an index diagnosis of aURTI between 2010 and 2018, who had prescriptions for either homeopathic, conventional cough & cold, nasal, or throat medicines, or nonopioid analgesics on the day of diagnosis or within six days afterwards. aURTI recurrence was assessed by multivariable logistic regression, the number of antibiotic prescriptions by multivariable negative binomial regression.

Results: From 3,628,295 patients with aURTI diagnosis initially identified in the database in the relevant time interval, a total of 610,118 patients, fulfilling the in- and not violating the exclusion criteria, were retained for analysis. In the multivariate analyses on all patients, prescriptions of nasal medicines were associated with a significant, slightly higher (OR: 1.18, CI: 1.10-1.26, p<0.001) risk of aURTI recurrence compared to homeopathic medicines within 12 months. Prescriptions of cough & cold (OR: 0.92, CI: 0.86-0.97, statistically significant, p=0.005) as well as throat medicines (OR: 0.93, CI: 0.86-1.01, p=0.086), and nonopioid analgesics (OR: 0.95, CI: 0.89-1.02, p=0.181) were associated with slightly lower risk of aURTI recurrence compared to homeopathic medicines. In the analysis of the age-dependent subgroups, there were some deviations from the overall population in terms of statistical significance; however, the directions of the effect estimates were unchanged. Almost all results of negative binomial regression analyses assessing differences in the frequency of antibiotic prescriptions during follow-up, both in all patients and in the age-dependent subgroups were statistically significant in favor of homeopathic medicines.

Conclusion: The study demonstrated that follow-up recurrence and antibiotic prescriptions in patients with uncomplicated aURTI are at least comparable between patients treated with homeopathic and conventional medicines in real-world practice. Despite some methodological limitations inherent to the used database, the results of this study indicate that homeopathic medicines present a valuable therapeutic option for managing aURTI.