Echinacea purpurea: An overview of mechanism, efficacy, and safety in pediatric upper respiratory infections and otitis media

Abstract

Pediatric upper respiratory infections (URIs) and otitis media (OM) significantly impact the health of children globally. Echinacea purpurea, known for its immunomodulatory, anti-inflammatory, and antimicrobial properties, has been historically used to treat various ailments, suggesting its potential as an adjunctive treatment in pediatric respiratory conditions. This narrative review synthesizes literature from January 2000 to December 2023 on the efficacy and safety of E. purpurea in treating pediatric URIs, including OM. It focuses on clinical trials and empirical studies that explore the mechanisms of action, such as the modulation of cytokine production, inhibition of NF-κB signaling, and antimicrobial effects. The analysis reveals mixed outcomes regarding the efficacy of E. purpurea in pediatric populations, attributed partly to variability in study designs and lack of standardized treatment protocols. While some studies report reduced severity and duration of respiratory symptoms, others indicate minimal or no significant difference compared to placebo. The review also highlights the need for specifically designed products that cater to the unique physiological and metabolic needs of children. Rigorous, well-designed clinical trials are crucial for establishing clear guidelines on the use of E. purpurea in pediatric respiratory care, ensuring its safe and effective application in improving health outcomes for children.