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.[36]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
[37]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
[38]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
[39]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
[40]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 randomized trial in China indicated that use of Gankeshuangqing may decrease acute bronchitis (called wind-heat syndrome) symptoms, with no adverse events reported.[41]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.[42]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
[43]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 randomized placebo-controlled trial found that it improved bronchitis symptoms scores, owing to a decrease in cough.[44]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 randomized 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.[45]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. One small randomized controlled study using Spicae aetheroleum, an extract obtained from the flower portion of the Lavandula latifolia plant, showed a 25% reduction in symptom scores in patients with acute bronchitis along with improvements in quality of life scores. Patients in this study had no adverse side effects. Based on the small number of participants in this study, additional evidence is needed to determine how beneficial this supplement is for patients with acute bronchitis.[46]Kähler C, Derezinski T, Bocian-Sobkowska J, et al. Spicae aetheroleum in uncomplicated acute bronchitis: a double-blind, randomised clinical trial. Wien Med Wochenschr. 2019 Apr;169(5-6):137-148.
https://www.doi.org/10.1007/s10354-017-0612-0
http://www.ncbi.nlm.nih.gov/pubmed/29209859?tool=bestpractice.com