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Research project: Andrographis paniculata (Chuan Xin Lian) for symptomatic relief of acute respiratory tract infections in adults and children: a systematic review and meta-analysis

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Respiratory tract infections are one of the most common reasons for GP consultations in the UK and 75% of all antibiotic prescribing arises in this setting. Antibiotics are of very limited benefit in the majority of uncomplicated infections. One of the biggest motivations supporting this area of research, is the evolving global threat to public health of anti-microbial resistance.

Related research groups

Primary Care, Population Sciences and Medical Education

Andrographis, also known as the king of bitters, has traditionally been used as an antipyretic for relieving and reducing the severity and duration of symptoms of common colds and alleviating fever, cough and sore throats. The aim of this systematic review is to evaluate the clinical effectiveness and safety of Andrographis for symptoms of acute RTIs (ARTIs).

English and Chinese databases were searched from their inception to March 2016 for randomised controlled trials evaluating oral Andrographis without language barriers (Protocol ID: CRD42016035679). The primary outcomes were improvement in ARTI symptoms and adverse events (AEs). A random effects model was used to pool the mean differences and risk ratio with 95% CI reported. Methodological quality was evaluated using the Cochrane risk of bias tool; two reviewers independently screened eligibility and extracted data.

The systematic review assessed data for 7175 patients across 33 trials in six countries. The overall findings suggested the herb appears both safe and helpful in improving cough and sore throat, and shortened the duration of sore throat and sick leave. But there were variations in the forms of the Andrographis and different regimens so the overall findings were weakened due to heterogeneity. The methodological and reporting quality of included studies was both limited. It was unclear in most studies whether the herb used were undergone strict quality control process thus the consistency of their contents could not be guaranteed.

The team is starting a formal trial in the UK to confirm these findings and to measure the impact on antibiotic prescribing.

INVESTIGATORS: Lily Lai, George Lewith


Duration: February 2016 to January 2017


Publication: Andrographis paniculata (Chuan Xin Lian) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. Xiao-Yang Hu, Ruo-Han Wu, Martin Logue, Clara Blondel, Lily Yuen Wan Lai, Beth Stuart, Andrew Flower, Yu-Tong Fei, Michael Moore, Jonathan Shepherd, Jian-Ping Liu, George Lewith.  



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