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Acute Infections and Fever

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AM postulates that fever can be of short-term and long-term benefit in several ways. A systematic review of the scientific evidence showed that many of the opinions expressed by AM authors on acute infections and fever have become evidence-based (1)
http://dx.doi.org/10.1155/2016/3642659 and http://warmuptofever.org/en/).
In AM, treatment of upper respiratory tract infections (URTI/OM) fever is not routinely suppressed with analgesics, and antibiotics are only prescribed if clearly needed. For alleviation of fever and other symptoms, priority is given to AM medications and nonmedication treatment such as steam inhalations, nasal lavage, and various external applications (cold dressings on legs to lower temperature, local compresses etc.) (1–5). In prospective observational studies of adults and children treated for URTI/OM by qualified AM physicians in routine primary care settings, very low use of antibiotics (1.5-7.5% of patients) and analgesics/antipyretics (0.0-9.1%) has been reported, without increased risk for complications (6–9).
Most patients in these studies were children. In a subgroup analysis of children from one study, a comparative multicenter study conducted in four European countries (AT, DE, NL, UK) and the USA (6), the difference between patients treated by AM physicians and physicians providing conventional care (CON), respectively, were striking: during the four-week follow-up, antibiotics were prescribed to 5.0% versus 25.6% of AM and CON patients, respectively, analgesics/antipyretics were prescribed to 3.2% versus 25.6%. In addition AM patients had quicker symptom resolution and higher caregiver satisfaction.  These differences could not be explained by age, gender, chief complaint and four markers of baseline morbidity. Although data had been collected in 1999-2000 and antibiotic prescription for URTI/OM has reportedly been reduced since then, antibiotic prescription rates in this study (5% in the AM group) were still much lower than in similar observational studies of URTI/OM from 2006-2012 (range 31% to 84%) (6).

These data provide a basis for further work on this topic that is presently being carried out by the CARE 2 group (contact David.martin@uni-wh.de).

January 2018

Univ.-Prof. Dr. med. David Martin
Witten/Herdecke University

Dr. med. Harald J. Hamre
IFAEMM Freiburg at the Witten/Herdecke University
ESCAMP - European Scientific Cooperative on Anthroposophic Medicinal Products

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References

(1) Martin DD. Fever: Views in Anthroposophic Medicine and their Scientific Validity. Evid Based Complement Alternat Med. 2016;2016(1):13 pages.

(2) Soldner G, Stellman HM. Individual Paediatrics: Physical, Emotional and Spiritual Aspects of Diagnosis and Counseling - Anthroposophic-homeopathic Therapy, Fourth edition. 4 edition. CRC Press; 2014. 984 S.

(3) Glöckler M, Goebel W. A Guide to Child Health: A Holistic Approach to Raising Healthy Children. Floris Books; 2013.

(4) Goebel MW, Michael MK, Glöckler MM. Kindersprechstunde: ein medizinisch-pädagogischer Ratgeber. Verlag Urachhaus; 2016.

(5) Szoeke H, Marodi M, Sallay Z, Székely B, Sterner M-G, Hegyi G. Integrative versus Conventional Therapy of Chronic Otitis Media with Effusion and Adenoid Hypertrophy in Children: A Prospective Observational Study. Forsch KomplementärmedizinResearch Complement Med. 2016;23(4):231–239.

(6) Hamre HJ, Glockmann A, Schwarz R, Riley DS, Baars EW, Kiene H, u. a. Antibiotic use in children with acute respiratory or ear infections: prospective observational comparison of anthroposophic and conventional treatment under routine primary care conditions. Evid Based Complement Alternat Med. 2014;2014(Article ID 243801).

(7) Hamre HJ, Fischer M, Heger M, Riley D, Haidvogl M, Baars E, u. a. Anthroposophic vs. conventional therapy of acute respiratory and ear infections. Wien Klin Wochenschr. 2005;117(7–8):256–268.

(8) Hamre HJ, Glockmann A, Fischer M, Riley DS, Baars E, Kiene H. Use and Safety of Anthroposophic Medications for Acute Respiratory and Ear Infections: A Prospective Cohort Study. Drug Target Insights. 14. September 2007;2:209–19.

(9) Jeschke E, Lüke C, Ostermann T, Tabali M, Huebner J, Matthes H. Verordnungsverhalten anthroposophisch orientierter Ärzte bei akuten Infektionen der oberen Atemwege. Forsch KomplementärmedizinResearch Complement Med. 2007;14(4):207–215.