Homeopathy is a popular form of alternative medicine based on the concept of "similars" -- the idea that the same substance that could make a person ill in large amounts could actually relieve symptoms of that illness in very small amounts. In other words, that which doesn't kill you makes you stronger.
The applications of homeopathy are widespread -- everything from treating the common cold to clearing up childhood ear infections. It's this latest use that caught the attention of a group of West Coast researchers, who set out to evaluate in a scientific way the many reports of homeopathic success.
"We set this up as a pilot study, not really expecting to see any positive effect from homeopathy," says researcher Jennifer Jacobs, MD, MPH, clinical assistant professor of epidemiology at the University of Washington School of Public Health and Community Medicine in Seattle. "We were surprised that homeopathy decreased symptoms [of middle ear infections] in the first 24 hours of treatment."
The implications are important. Not only did the researchers determine that individualized homeopathic treatments can give early relief to the ear pain, fever, and fussiness associated with ear infections, they also say such treatment could potentially help reduce antibiotic use in children, something which has been associated with increasing rates of antibiotic resistance.
The study, which appears in the February issue of the Pediatric Infectious Disease Journal, was funded by the Standard Homeopathic Company and took place in a private pediatric practice in Seattle. Children with middle ear infection received either a homeopathic remedy geared to their specific symptoms, or a placebo. They took the pills three times daily for five days, or until their ear pain and fever got better, whichever came first.
The children, aged 18 months to 6 years, were divided into two groups, with 36 receiving homeopathic treatment and 39 getting placebo. Neither the researchers nor the parents knew which treatment each child got until the study was over.
Eight different homeopathic remedies were given in combinations that were individualized for each child, depending on his or her mood, type of pain, amount of thirst, and length of time with symptoms. The most commonly used remedies were Pulsatilla (windflower), Chamomilla (German chamomile), Sulfur (elemental sulfur), and Calcarea carbonica (calcium carbonate).
At the beginning of treatment, all the children had fluid in the middle ear and had suffered ear pain and/or fever -- but for less than 36 hours. The doctors examined them for objective measures of ear infection, specifically fluid in the middle ear. They also looked at subjective measures by asking parents and children to report in a diary whether they felt less pain and had less fever during the course of treatment.
To assess the treatment, doctors checked the children after five days, two weeks, and six weeks, and found that over this range of time, 10-20% of the homeopathy group showed more signs of improvement than the kids taking placebo. The researchers admit the study was too small to know for sure if this difference could be explained by chance alone, or to tell if the homeopathic treatment reduced the need for antibiotics.
But when the researchers looked at the symptom diaries, they found that at 24 and 64 hours after treatment, the children who got the homeopathic treatment reported significantly less ear pain and fever than those who received placebo.
"This finding may actually be more important ... since early symptom relief may help prevent overuse of antibiotics," Jacobs says.
In light of increasing fears concerning antibiotic resistance, many pediatricians are adopting a "watch and wait" approach to ear infections, reserving antibiotic use for those children who do not improve within a couple of days.
As there are essentially no side effects from homeopathic medications, parents can safely give them to their children at the first sign of ear infection. "Homeopathic medications are good to decrease symptoms while we're waiting for the body to do its work and fight off the infection," Jacobs says. "And kids like taking them because of their sweet taste."
If high fever and ear pain persist after 24 hours, Jacobs recommends that parents consult their pediatrician, who may then elect to start appropriate antibiotics.
"On its own, ... this study is not sufficient to warrant a conclusion that homeopathy is effective for [ear infections]," says Andrew Vickers, PhD, an independent research consultant to the Royal London Homoeopathic Hospital in the U.K., who was asked to review the study for WebMD. Nevertheless, Vickers finds the study "provocative" and suggests it be replicated with a larger number of patients.
Ralph Ballard, MD agrees that more research is needed and recommends that future studies compare homeopathy to both placebo and to antibiotic treatment. Ballard is a professor of family medicine at Monash University in Victoria, Australia.
And although she agrees that homeopathy deserves more rigorous evaluation, Australian doctor Marie Pirotta predicts there may be difficulties in doing so. Because homeopathic treatments are created individually for each patient, it may be impossible to design a traditional scientific study to compare them.
"This is always going to be a problem with trials of this type," says Pirotta, who teaches at the University of Melbourne in Carlton, Australia.