Review Article

The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies

Table 1

Studies on prescription and consumption rates of antibiotics in CAM practices and in families with an alternative lifestyle.

Study typeResultsStudy characteristics

Cross-sectional study comparing children from anthroposophic families and children with a non-anthroposophic lifestyle [28]Past use of antibiotics:
(i) anthroposophic children: 52%
(ii) non-anthroposophic children: 90%
(odds ratio (OR): 0.62, 95% CI: 0.43 - 0.91)
N = 295 anthroposophic children and 380 non-anthroposophic children, age 5-13 years.
Sweden

Cross-sectional study comparing children from anthroposophic families and children with a non-anthroposophic lifestyle [29]Antibiotics use ever, in the first 12 months of life and after 12 months of life:
(i) all significantly lower in children with an anthroposophic lifestyle (p < 0.001)
N = 6.630 children, age 5-13 years (4.606 from Steiner schools and 2.024 from reference schools) in 5 European countries (Austria, 11%; Germany, 39%; The Netherlands, 22%; Sweden, 9%; Switzerland, 20%)

KOALA Birth Cohort Study comparing families with an alternative and a non-alternative lifestyle [30]Families with an alternative lifestyle:
(i) antibiotic use was less frequent (13.8% vs. 24.1%) (p-value not presented)
N= 2.343 conventional children and 491 alternative lifestyle children.
The Netherlands

Observational study on prescribing practices of anthroposophic medicine (AM) doctors in the treatment of upper respiratory tract infections [31]Prescription rate for antibiotics (6.3%) was well below the German average21.818 prescriptions for 12.081 patients (73.7% children) with 19.050 cases of URTI were analysed.
Antibiotics were given in 6.3% of cases (minimum: common cold 1.9%, maximum: tonsillitis 24.3%).
Germany

Prospective, non-randomised comparison of outcomes in patients self-selected to anthroposophic or conventional therapy under real-world conditions [10]5.5% of the patients in the AM group and 33.6% in the conventional group received antibiotics (p < 0.0001)29 primary care practices (Austria, Germany, Netherlands, UK and USA). N= 1.016 outpatients, age ≥ 1 month, consulting an anthroposophic (N = 715) or conventional physician (N = 301) with a chief complaint of acute (≤ 7 days) sore throat, ear pain, sinus pain, runny nose or cough

Prospective, non-randomised comparison of outcomes in patients self-selected to anthroposophic or conventional therapy under real-world conditions [32]5.5% of the patients in the AM group and 25.6% in the conventional group received antibiotics (p < 0.001)N = 529 children <18 years from Europe (Austria, Germany, Netherlands, and UK) or USA with acute respiratory or ear infections

Observational study on the treatment of patients with upper respiratory tract infections: homeopathic GPs vs. conventional GPs [33]Significantly lower consumption of antibiotics (OR=0.43, 95% CI: 0.27-0.68) in the homeopathic patients groupN = 518 adults and children with URTI (79.3% rhinopharyngitis).
France

Randomized trial, children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation [34]Significantly less antibiotic use in the homeopathic group (26.9% vs. 41.2%) (p-value not presented)N = 456 patient visits were compared: 281 received homeopathy, 175 received conventional medicine.
Germany, Switzerland, Austria, USA

Observational study among parents of children [35]Use of homeopathic products not associated with decreased antibiotic consumption (adjusted OR = 1.02, 95% CI: 0.84 - 1.24).N = 9.723 parents of children, age: 3–4.5 years.
United Kingdom