Echinacea for Treating Colds in ChildrenEchinacea for Treating Colds in Children

To the Editor: Dr Taylor and colleagues¹ concluded that a nonstandardized dose of Echinacea purpurea did not decrease the severity or duration of upper respiratory tract infections (URIs) in children 2 to 11 years old. We have several concerns about the authors' methods. First, the dosage was not determined, nor did the authors measure lipophilic phenol or hydrophilic polysaccharide fractions. The lack of standardization calls into question the relevance of the outcomes compared with other commercially available standardized echinacea preparations.² Furthermore, fractions derived from whole echinacea (roots, seeds, leaves, and flowers) represent a broader spectrum of potentially bioactive compounds and biological activity.^{3 - 4}

The placebo group used significantly more vitamins and/or mineral supplements than the echinacea group. There is evidence that vitamins and minerals may be therapeutic for URIs.⁵ Although the specific vitamin and mineral dosages were not identified, the potential effect of these supplements contributing to the recovery and severity of URI is unknown and may have confounded the results in the placebo group.

Echinacea has been hypothesized to be more effective when used to support the body's immune response at the first sign of a URI, and not after 2 or more symptoms have been established.⁶ The limited benefit noted in efficacy may be due to the late timing of administration; however, the authors did note a significantly lower URI recurrence rate in the group treated with echinacea compared with the placebo group. This may indicate the need for more timely intervention with echinacea than the authors provided.