Alternative/herbal medicines
Several natural products have been studied for the treatment of acute bronchitis. Based on a small number of studies conducted in Eastern Europe, Pelargonium sidoides (also known as EPs 7630) has been shown to reduce acute bronchitis symptom duration and intensity.[34]Timmer A, Günther J, Motschall E, et al. Pelargonium sidoides extract for acute respiratory tract infections. Cochrane Database Syst Rev. 2013;(10):CD006323.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006323.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/24146345?tool=bestpractice.com
[35]Agbabiaka T, Guo R, Ernst E. Pelargonium sidoides for acute bronchitis: A systematic review and meta-analysis. Phytomedicine. 2008;15:378-385.
http://www.ncbi.nlm.nih.gov/pubmed/18222667?tool=bestpractice.com
[36]Kamin W, Maydannik V, Malek FA, et al. Efficacy and tolerability of EPs 7630 in children and adolescents with acute bronchitis: a randomized, double-blind, placebo-controlled multicenter trial with a herbal drug preparation from Pelargonium sidoides roots. Int J Clin Pharmacol Ther. 2010;48:184-191.
http://www.ncbi.nlm.nih.gov/pubmed/20197012?tool=bestpractice.com
[37]Kamin W, Maydannik VG, Malek FA, et al. Efficacy and tolerability of EPs 7630 in patients (aged 6-18 years old) with acute bronchitis. Acta Paediatr. 2010;99:537-543.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855831/
http://www.ncbi.nlm.nih.gov/pubmed/20070280?tool=bestpractice.com
[38]Matthys H, Lizogub VG, Malek FA, et al. Efficacy and tolerability of EPs 7630 tablets in patients with acute bronchitis: a randomised, double-blind, placebo-controlled dose-finding study with a herbal drug preparation from Pelargonium sidoides. Curr Med Res Opin. 2010;26:1413-1422.
http://www.ncbi.nlm.nih.gov/pubmed/20387996?tool=bestpractice.com
A single small placebo-controlled randomised trial in China indicated that use of Gankeshuangqing may decrease acute bronchitis (called wind-heat syndrome) symptoms, with no adverse events reported.[39]Ding HY, Zhang N-ZW, Chen B, et al. A multicentered, double-blind, randomized controlled trials of Gankeshuangqing Capsule in the treatment of wind-heat syndrome (acute upper respiratory infection or acute bronchitis). Chin J Evid Based Med. 2010;1:14-22. Further studies suggest that ivy extract may reduce coughing fits and overall cough in patients with acute bronchitis.[40]Kemmerich B, Eberhardt R, Stammer H. Efficacy and tolerability of a fluid extract combination of thyme herb and ivy leaves and matched placebo in adults suffering from acute bronchitis with productive cough: a prospective, double-blind, placebo-controlled clinical trial. Arzneimittelforschung. 2006;56:652-660.
http://www.ncbi.nlm.nih.gov/pubmed/17063641?tool=bestpractice.com
[41]Cwientzek U, Ottillinger B, Arenberger P. Acute bronchitis therapy with ivy leaves extracts in a two-arm study. A double-blind, randomised study vs. an other ivy leaves extract. Phytomedicine. 2011;18:1105-1109.
http://www.ncbi.nlm.nih.gov/pubmed/21802921?tool=bestpractice.com
Cineole (eucalyptol), the main component of eucalyptus oil, has been observed to increase mucociliary beat rates and has bronchodilating effects. One randomised placebo-controlled trial found that it improved bronchitis symptoms scores, owing to a decrease in cough.[42]Fischer J, Dethlefsen U. Efficacy of cineole in patients suffering from acute bronchitis: a placebo-controlled double-blind trial. Cough. 2013;9:25.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3842692/
http://www.ncbi.nlm.nih.gov/pubmed/24261680?tool=bestpractice.com
Similar results were obtained in another randomised controlled trial of a preparation containing cineole, in which patients had a reduction in several cough-related symptoms, including night cough, coughing fits, and overall impairment.[43]Gillissen A, Wittig T, Ehmen M, et al. A multi-centre, randomised, double-blind, placebo-controlled clinical trial on the efficacy and tolerability of GeloMyrtol® forte in acute bronchitis. Drug Res (Stuttg). 2013;63:19-27.
http://www.ncbi.nlm.nih.gov/pubmed/23447044?tool=bestpractice.com
More trials are needed to assess the overall effectiveness and safety of these products.