In paediatric patients herbal products are used to promote health, to prevent illness and to treat acute but overall chronic, recurrent or incurable conditions such as asthma, atopic dermatitis, allergic rhinitis, cystic fibrosis, inflammatory bowel disease, rheumatoid arthritis or cancer.
Regarding the important aspect of efficacy of such treatments in young patients, some studies have revealed promising results, while in other cases no clinical evidence of effectiveness has been demonstrated. In one study, herbal teas containing chamomile seemed to have a favourable effect on infantile colic . Two controlled trials involving a limited number of subjects have been performed on the use of cranberry for the prevention and treatment of urinary tract infections in children with neurogenic bladder [82, 83]: both studies suggested that cranberry juice was not effective. Echinacea is commonly used to prevent and treat the common cold and respiratory tract infections, but its usefulness in children has yet to be clearly demonstrated. A randomized placebo-controlled trial involving 524 children 2 to 11 years old assessed the efficacy of this herbal product in reducing the duration and/or severity of upper respiratory symptoms . Echinacea was not effective and its use was associated with an increased risk of rash. Other authors investigated the clinical efficacy of Echinacea in an observational study in which 1322 children were suffering from recurring upper respiratory infections. Herbal treatment was effective either in resolving symptoms or in shortening the duration of illness, but there was no placebo comparison . Clinical experience suggests that the use of herbal remedies such as St John's wort in children and adolescents with affective disorders is increasing. Preliminary findings [86, 87] indicate that St John's wort may be clinically effective in the treatment of juvenile depression. Six clinical trials have assessed the efficacy of evening primrose oil used in paediatric populations to cure atopic dermatitis [88, 91] and hyperactivity disorders [92, 93]. The administration of this herbal product produced only minimal or no behavioural improvements in 49 hyperactive children, while some benefits were observed in the treatment of atopic dermatitis. Supplementation of evening primrose oil has also been evaluated in 11 diabetic children , but it remains unknown if this kind of therapy may have a preventive effect on diabetic vascular complications.
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