You are a paediatric specialist registrar on a Sunday late shift in the accident and emergency department. A 4 year old boy presents with a two day history of fever (maximum temperature 38.8°C) and clinical signs of an upper respiratory tract infection (URTI). At home, his mother gave regular paracetamol to treat his fever and extracts from ivy to alleviate the cough. She asks you about Echinacea purpurea therapy for her son’s illness.

Structured clinical question

In children with upper respiratory tract infection [patient], is treatment with Echinacea purpurea [intervention] effective for alleviating symptoms and shortening the course of URTI [outcome]?

Search strategy and outcome

Cochrane Database of Systematic Reviews: 1 relevant hit.

Pubmed: “Echinacea” AND (“respiratory infection” OR “cold”). Limits: “Randomized controlled trial” or “clinical trial”. 15 hits, 7 relevant. “Echinacea” AND (“respiratory infection” OR “cold”) AND (“children” OR “infants”). …