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Review
. 2015 Jan 28;1(1):CD001957.
doi: 10.1002/14651858.CD001957.pub6.

Homeopathic Oscillococcinum® for Preventing and Treating Influenza and Influenza-Like Illness

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Free PMC article
Review

Homeopathic Oscillococcinum® for Preventing and Treating Influenza and Influenza-Like Illness

Robert T Mathie et al. Cochrane Database Syst Rev. .
Free PMC article

Abstract

Background: Influenza is a highly infectious viral disease that is particularly common in the winter months. Oscillococcinum® is a patented homeopathic medicine that is made from a 1% solution of wild duck heart and liver extract, which is then serially diluted 200 times with water and alcohol.

Objectives: To determine whether homeopathic Oscillococcinum® is more effective than placebo in the prevention and/or treatment of influenza and influenza-like illness in adults or children.

Search methods: We searched CENTRAL (2014, Issue 8), MEDLINE (1966 to August week 4, 2014), MEDLINE In-Process & Other Non-Indexed Citations (4 September 2014), AMED (2006 to September 2014), Web of Science (1985 to September 2014), LILACS (1985 to September 2014) and EMBASE (1980 to September 2014). We contacted the manufacturers of Oscillococcinum® for information on further trials.

Selection criteria: Randomised, placebo-controlled trials of Oscillococcinum® in the prevention and/or treatment of influenza and influenza-like illness in adults or children.

Data collection and analysis: Three review authors independently extracted data and assessed risk of bias in the eligible trials.

Main results: No new trials were included in this 2014 update. We included six studies: two prophylaxis trials (327 young to middle-aged adults in Russia) and four treatment trials (1196 teenagers and adults in France and Germany). The overall standard of trial reporting was poor and hence many important methodological aspects of the trials had unclear risk of bias. There was no statistically significant difference between the effects of Oscillococcinum® and placebo in the prevention of influenza-like illness: risk ratio (RR) 0.48, 95% confidence interval (CI) 0.17 to 1.34, P value = 0.16. Two treatment trials (judged as 'low quality') reported sufficient information to allow full data extraction: 48 hours after commencing treatment, there was an absolute risk reduction of 7.7% in the frequency of symptom relief with Oscillococcinum® compared with that of placebo (risk difference (RD) 0.077, 95% CI 0.03 to 0.12); the RR was 1.86 (95% CI 1.27 to 2.73; P value = 0.001). A significant but lesser effect was observed at three days (RR 1.27, 95% CI 1.03 to 1.56; P value = 0.03), and no significant difference between the groups was noted at four days (RR 1.11, 95% CI 0.98 to 1.27; P value = 0.10) or at five days (RR 1.06, 95% CI 0.96 to 1.16; P value = 0.25). One of the six studies reported one patient who suffered an adverse effect (headache) from taking Oscillococcinum®.

Authors' conclusions: There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling. There was no evidence of clinically important harms due to Oscillococcinum®.

Conflict of interest statement

All three review authors are research‐active in the field of homeopathy. They were members of the International Scientific Committee for Homeopathic Investigations (ISCHI), whose membership also included two employees of Boiron (the manufacturers of Oscillococcinum®), and whose committee activities ceased in July 2013. Progress with the Cochrane Review on Oscillococcinum® was presented briefly at ISCHI meetings in 2010 and 2011. The drafting of this Cochrane Review was carried out independently of those communications and of the authors' other ongoing research activity. ISCHI has not run or sponsored any research on Oscillococcinum®.

Robert T Mathie: Dr Mathie is Research Development Adviser, British Homeopathic Association. He was a member of the International Scientific Committee on Homeopathic Investigations, which ceased its committee activities in July 2013. Joyce Frye: Part of Dr Frye's salary was supported by a research grant from the Standard Homeopathic Company, paid to her employer, the Center for Integrative Medicine, Department of Family Medicine, University of Maryland, USA. Support ended in June 2013 when Dr Frye resigned from the University of Maryland. Standard Homeopathic Company does not manufacture Oscillococcinum or any similar product, and had no interest in the outcome of the review. Dr Frye received honoraria from the International Scientific Committee on Homeopathic Investigations, which was dissolved in July 2013. Peter Fisher: I am Expert Adviser on Complementary and Alternative Medicine to the National Institute for Health and Clinical Excellence (NICE), which may take an interest in the evidence in this review. I am Editor in Chief of an international, peer‐reviewed journal dedicated to homeopathy. All payments and reimbursements for lectures have been from universities or professional or learned societies. None of these lectures has been dedicated to the subject of this review. Some meetings have been supported by grants from commercial interests, including the manufacturer of the product that is the subject of the review.

Figures

1
1
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
2
2
Forest plot of comparison: 1 Prevention: Oscillococcinum versus placebo. Outcome 1: Occurrence of influenza‐like illness.
3
3
Forest plot of comparison: 2 Treatment: Oscillococcinum versus placebo. Outcome 1: Absence of symptoms at 48 hours ‐ patient assessment.
4
4
Forest plot of comparison: 2 Treatment: Oscillococcinum versus placebo. Outcome 20: Absence of symptoms at 3 days ‐ patient assessment.
5
5
Forest plot of comparison: 2 Treatment: Oscillococcinum versus placebo. Outcome 21: Absence of symptoms at 4 days ‐ patient assessment.
6
6
Forest plot of comparison: 2 Treatment: Oscillococcinum versus placebo. Outcome 22: Absence of symptoms at 5 days ‐ patient assessment.
1.1
1.1. Analysis
Comparison 1 Prevention: Oscillococcinum versus placebo, Outcome 1 Occurrence of influenza‐like illness.
2.1
2.1. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 1 Absence of symptoms at 48 hours ‐ patient assessment.
2.2
2.2. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 2 Absence of symptoms at 48 hours ‐ patient assessment ‐ by age.
2.3
2.3. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 3 Absence of symptoms at 48 hours ‐ patient assessment ‐ by severity of symptoms.
2.4
2.4. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 4 Fitness for work at 2 days.
2.5
2.5. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 5 Fitness for work at 4 days.
2.6
2.6. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 6 No chills at 48 hours.
2.7
2.7. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 7 No fever at 48 hours.
2.8
2.8. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 8 No rhinitis at 48 hours.
2.9
2.9. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 9 No general aches at 48 hours.
2.10
2.10. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 10 No headache at 48 hours.
2.11
2.11. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 11 No backache at 48 hours.
2.12
2.12. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 12 No spinal pain at 48 hours.
2.13
2.13. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 13 No muscle pain at 48 hours.
2.14
2.14. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 14 No articular pain at 48 hours.
2.15
2.15. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 15 No night cough at 48 hours.
2.16
2.16. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 16 No day cough at 48 hours.
2.17
2.17. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 17 Temperature at 48 hours.
2.18
2.18. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 18 Improvement in symptoms at 48 hours ‐ physician assessment.
2.19
2.19. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 19 Absence of symptoms at 48 hours ‐ physician assessment.
2.20
2.20. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 20 Absence of symptoms at 3 days ‐ patient assessment.
2.21
2.21. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 21 Absence of symptoms at 4 days ‐ patient assessment.
2.22
2.22. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 22 Absence of symptoms at 5 days ‐ patient assessment.
2.23
2.23. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 23 Increased use of concomitant medication during trial.
2.24
2.24. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 24 Medication used for pain or fever.
2.25
2.25. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 25 Medication used for cough or coryza.
2.26
2.26. Analysis
Comparison 2 Treatment: Oscillococcinum versus placebo, Outcome 26 Antibiotics used.

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