Echinacea purpurea has been shown to broadly inhibit coronaviruses and SARS-CoV-2 in vitro. This review discusses the available clinical evidence from randomized, blinded and controlled human studies. Two RCTs capturing incidence of viral respiratory tract infections during Echinacea preventative treatment were identified including coronavirus infections. Incidence and/or viral loads were measured by RT-PCR and symptom severity was recorded. In a first study, Jawad et al. collected nasopharyngeal swabs from adults (N = 755) over 4 months of continuous prevention. Overall, 24 and 47 enveloped virus infections occurred, including 21 and 33 coronavirus detections (229E; HKU1; OC43) with Echinaforce^® extract (2400 mg daily) and placebo, respectively (p = 0.0114). In a separate study, Ogal et al. administered the same extract (1200 mg) or control for 4 months to children (4–12 years) (N = 203). Echinacea reduced the incidence of enveloped virus infections from 47 to 29 (p = 0.0038) whereas 11 and 13 coronavirus detections (229E, OC43, NL63) were counted (p > 0.05). Respiratory symptoms during coronavirus infections were significantly lower with area-under-curve AUC = 75.8 (+/−50.24) versus 27.1 (+/−21.27) score points (p = 0.0036). Importantly, viral loads in nasal secretions were significantly reduced by 98.5% in the Echinacea group, with Ct-values 31.1 [95% CI 26.3; 35.9] versus 25.0 [95% CI 20.5; 29.5] in the control group (p = 0.0479). Results from clinical studies confirm the antiviral activity found for Echinacea in vitro, embracing enveloped respiratory pathogens and therefore coronaviruses as well. Substantiating results from a new, completed study seem to extrapolate these effects to the prevention of SARS-CoV-2 infections. As hypothesized, the established broad antiviral activity of Echinacea extract appears to be inclusive for SARS-CoV-2.

Respiratory tract infections (RTIs) are the leading cause of antibiotic prescriptions, primarily due to the risk for secondary bacterial infections. In this study, we examined whether Echinacea could reduce the need for antibiotics by preventing RTIs and their complications, and subsequently investigated its safety profile. A comprehensive search of EMBASE, PubMed, Google Scholar, Cochrane DARE and clinicaltrials.gov identified 30 clinical trials (39 comparisons) studying Echinacea for the prevention or treatment of RTIs in 5652 subjects. Echinacea significantly reduced the monthly RTI occurrence, risk ratio (RR) 0.68 (95% CI 0.61–0.77) and number of patients with ≥1 RTI, RR = 0.75 [95% CI 0.69–0.81] corresponding to an odds ratio 0.53 [95% CI 0.42–0.67]. Echinacea reduced the risk of recurrent infections (RR = 0.60; 95% CI 0.46–0.80), RTI complications (RR = 0.44; 95% CI 0.36–0.54) and the need for antibiotic therapy (RR = 0.60; 95% CI 0.39–0.93), with total antibiotic therapy days reduced by 70% (IRR = 0.29; 95% CI 0.11–0.74). Alcoholic extracts from freshly harvested Echinacea purpurea were the strongest, with an 80% reduction of antibiotic treatment days, IRR 0.21 [95% CI 0.15–0.28]. An equal number of adverse events occurred with Echinacea and control treatment. Echinacea can safely prevent RTIs and associated complications, thereby decreasing the demand for antibiotics. Relevant differences exist between Echinacea preparations.

Background: The goal of this study was to evaluate whether the medical recommendation of Angocin^®Anti-Infekt N (heretofore referenced as Angocin^®) on the day of diagnosis of acute bronchitis is negatively associated with the recurrence of acute bronchitis diagnosis, antibiotic prescriptions, incidence of chronic bronchitis, and duration of sick leave. Methods: This study included patients in general practices in Germany with a first documented diagnosis of acute bronchitis between 2005 and 2022 (index date) and a prescription of Angocin^®, thyme products, essential oils, mucolytics or antibiotics on the index date. The association between Angocin^® prescription and the risks of a relapse of acute bronchitis, development of chronic bronchitis, or subsequent antibiotic prescription were evaluated using Cox regression models. Univariable conditional logistic regression models were used to investigate the association between Angocin^® prescription and duration of sick leave. Results: After a 1:5 propensity score matching, 598 Angocin^® patients and 2990 patients in each of the four comparison cohorts were available for analysis. Angocin^® prescription was associated with significantly lower incidence of a renewed confirmed diagnosis of acute bronchitis as compared to essential oils (Hazard ratio (HR): 0.61; 95% Confidence Interval (CI): 0.46–0.80), thyme products (HR: 0.70; 95% CI: 0.53–0.91), mucolytics (HR: 0.65; 95% CI: 0.49–0.85) or antibiotics (HR: 0.64; 95% CI: 0.49–0.84). Also, there were significantly lower incidences of subsequent re-prescriptions of antibiotics when compared to mucolytics (HR: 0.73; 95% CI: 0.53–0.99) or antibiotics (HR: 0.53; 95% CI: 0.39–0.72) and a significantly lower risk of chronic bronchitis as compared to essential oils (HR: 0.60; 95% CI: 0.46–0.78), thyme products (HR: 0.53; 95% CI: 0.41–0.69), mucolytics (HR: 0.49; 95% CI: 0.38–0.63) or antibiotics (HR: 0.59; 95% CI: 0.45–0.76). Conclusions: Considering the limitations of the study, the results shed light on the sustaining effectiveness of Angocin^® prescription in the management of acute bronchitis and the associated outcomes when compared to several other treatments commonly used for this condition.

Summary: Ätherische Öle (ÄÖ) als Vielstoffgemische sowie einzelne chemisch charakterisierte Ätherisch-Öl-Verbindungen (ÄÖV) haben zahlreiche pharmakologische Wirkungen, wie antibakterielle, antimykotische, antivirale, entzündungshemmende, immunmodulatorische, antioxidative und wundheilungsfördernde. Auf der Grundlage ausgewählter wissenschaftlicher Arbeiten befasst sich die vorliegende Übersicht mit den potenziellen antiviralen und viruziden Aktivitäten von ÄÖ und ÄÖV gegen behüllte und unbehüllte Viren. Neuere In-vitro- und In-vivo-Studien haben gezeigt, dass verschiedene Arznei- und Aromapflanzen antiviral und viruzid wirkende ÄÖ und ÄÖV enthalten, die in der Lage sind, in verschiedenen Wirtszelllinien die Vermehrung von DNA- und RNA-Viren zu behindern, indem sie wichtige Schritte des viralen Infektions-/Replikationszyklus blockieren. In-vivo-Studien an Mäusen mit Viren als Atemwegserreger haben gezeigt, dass verschiedene ÄÖ und ÄÖV das Leben infizierter Tiere verlängern, Virustiter in Gehirn und Lungengewebe reduzieren und die Biosynthese von proinflammatorischen Zytokinen hemmen können. Neuere Arbeiten auf technologischem Gebiet konnten nachweisen, dass nanoverkapselte ÄÖ/ÄÖV eine vielversprechende Möglichkeit darstellen, um die chemische Stabilität, Wasserlöslichkeit, Bioverfügbarkeit und antivirale Wirkung von ÄÖ und ÄÖV zu verbessern.

Unlängst äußerte das Deutsche Ärzteblatt in seinem nur für Ärzte zugänglichen Online-Infodienst unter dem Titel „Pflanzliche Präparate ohne Benefit für Rheumapatienten“, dass Patienten mit entzündlich rheumatischen Erkrankungen wenig bis gar nicht von den geläufigsten pflanzlichen Arzneimitteln profitierten [1]. Dieser Aussage liegt ein Bericht mit Empfehlungen der Kommission für Komplementäre Heilverfahren und Ernährung der Deutschen Gesellschaft für Rheumatologie und Klinische Immunologie e.V. (DGRh) unter Leitung von Prof. Dr. med. Gernot Keyßer, Universität Halle, zugrunde. Wir nehmen dies zum Anlass, die Ergebnisse vorzustellen und zu diskutieren, auch wegen der gründlichen Literaturrecherche und deren Aufarbeitung durch Vertreter einer renommierten wissenschaftlichen Fachgesellschaft. Article published online: 27 February 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

In den 1990er-Jahren gab es in Deutschland einen Boom in der Nutzung qualitätsgesicherter Arzneimittel aus Knoblauch, der ältesten Heilpflanze der Menschheit. Auch Grundlagen- und klinische Forschung waren damals nahezu weltweit führend. Als Hauptindikationsgebiete für Therapie und Forschung galten die relativ neu entdeckten Senkungen von Bluthochdruck und Hyperlipidämie, – Massenkrankheiten und wichtige Komponenten des metabolischen Syndroms. Drei Dekaden später ist bei uns die Verordnungspraxis für die 3 im Markt verbliebenen Arzneimittel mit Knoblauch auf verschwindendem Niveau, die entsprechende Forschung völlig zum Erliegen gekommen. Weltweit dagegen gibt es wesentlich mehr Forschung als damals, sowohl zu alten Indikationen aus Infektiologie, Hypertensiologie und dem Lipidstoffwechsel, aber auch neuen aus Onkologie, Diabetologie oder Neurologie. Diese Forschung wird hierzulande kaum wahrgenommen, obwohl seit wenigen Jahren RCT vorliegen, die einen günstigen Einfluss von Knoblauch auf die Progredienz der koronaren Herzerkrankung nahelegen. Aus Platzgründen sowie dem Schwerpunktthema dieses Heftes werden nur wichtige klinische Ergebnisse bezüglich Gefäßgesundheit referiert. Im Übrigen sei auf eine frühere, sehr ausführliche Beschäftigung mit Knoblauch in dieser Zeitschrift verwiesen [1] [2] [3]. In the 1990s, there was a boom in Germany in respect of quality-guaranteed medicinal products from garlic; the oldest medicinal plant known to humankind. Back then, Germany was among the global leaders in basic and clinical research. The main indications for therapy and research were the relatively newly discovered reductions in high blood pressure and hyperlipidaemia, mass diseases and important fragments of the metabolic syndrome. Three decades later, however, the prescription of the three remaining medicinal products with garlic-content has dwindled whereas research has come to a complete standstill. In contrast, worldwide research has considerably increased with regard to old indications in infectiology, hypertensiology and lipid metabolism, as well as new indications in oncology, diabetology and neurology. Comparable research is hardly noticed in Germany, in spite of the availability of randomized controlled trials (RCTs) for the past few years that suggest a favourable influence of garlic on the progression of coronary heart disease. Due to space constraints and the main focus of this current edition, only important clinical results relating to vascular health are reported. Reference is made to a very detailed discussion of garlic in earlier issues of this journal [1] [2] [3]. Article published online: 27 August 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany