Time to say good-bye? Homeopathy, skeptics and thoughts on how to proceed.

BACKGROUND: Although homeopathy is frequently used by many health professionals, there are ongoing debates concerning its effectiveness. Currently no unifying explanation how homeopathy works exists. Homeopaths are frequently challenged by skeptics, and in public opinion, the swan song for homeopathy is frequently sung. CONTENT: Regarding the efficacy of homeopathy, several well-designed RCTs, observational studies, case studies, and case reports, have been published, demonstrating its clinical efficacy. Regarding its mode of action, the discovery of the working principle of homeopathy would be a major advance towards a thorough scientific recognition of homeopathy. Basic research has already discovered some milestones, e.g., significant and reproducible effects of homeopathic preparations in plants. SUMMARY: To overcome the distrust of skeptics and public opinion, the support of basic research is indispensable. Second, homeopaths should continue to design prospective randomized clinical studies in order to create robust clinical evidence for the efficacy of homeopathy. Third, they should continue to publish their treatment outcomes, as these publications document clinical effectiveness beyond doubts about its mode of action. OUTLOOK: These measures will not only support homeopaths in continuing their clinical work, but may lead to a better recognition of this treatment in both the scientific world and the public.

Usefulness of Hydrastis for the prevention of encrustation of long-term indwelling catheters in persons with neurogenic bladder dysfunction: a case series.

INTRODUCTION: Virtually every person with a spinal cord injury (SCI) suffers from a neurogenic lower urinary tract dysfunction (NLUTD). In the long term, about 15% of persons with SCI depend on indwelling (suprapubic or transurethral) catheters for bladder management. About 50% of these patients suffer from catheter encrustation and blockage, which may become a vital threat for persons with SCI, as it can lead to septicemia or autonomic dysreflexia. Until today, no prophylaxis of catheter encrustations with an evidence-based proof of efficacy exists. CASE PRESENTATION: The homeopathic remedy Hydrastis, made from the goldenseal root, is used for the treatment of thick, mucous urine sediment. In four patients with tetraplegia (three female, one male) who managed NLUTD by suprapubic catheters, recurrent encrustations and catheter blockage occurred despite irrigation and medical treatment. Surgical urinary diversion was envisioned. Applying Hydrastis C30 once weekly as a long-term medication, in three of the four patients, catheter obstructions ceased, with a follow-up for at least 1 year. One patient is awaiting ileal conduit surgery. DISCUSSION: According to the results of our case series, the application of Hydrastis seems to be beneficial in the prevention of encrustations of indwelling catheters in patients with SCI. As the treatment was effective and well tolerated, the problem is frequent, and effective solutions are scarce, a prospective trial seems justified.

Homeopathic Treatment of a Lower Leg Edema-A Case Report.

BACKGROUND: Homeopathy is frequently and successfully used in daily clinical practice, so there is a need for well-documented case reports that illustrate its effectiveness. For this reason, we present a case in which homeopathy was used to treat an ankle and lower leg for spontaneous acute swelling and redness. CASE REPORT: A 54-year-old man presented with recurrence of a swollen left ankle and lower leg, which had previously been treated by conventional medicine. After case taking, a homeopathic treatment with Apis mellifica 200c led to a fast improvement. The patient was free of symptoms within 24 hours and has remained so for 3 years. CONCLUSION: Homeopathic treatment with Apis mellifica led to a fast and long-lasting improvement of an acute ankle swelling and reddening that had recurred after conventional medical therapy of similar symptoms.

Usefulness of classical homeopathy for the prophylaxis of recurrent urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction.

Context/Objective: to investigate the usefulness of classical homeopathy for the prevention of recurrent urinary tract infections (UTI) in patients with spinal cord injury (SCI). Design: prospective study. Setting: rehabilitation center in Switzerland. Participants: patients with chronic SCI and ≥3 UTI/year. Interventions: Participants were treated either with a standardized prophylaxis alone or in combination with homeopathy. Outcome measures: The number of UTI, general and specific quality of life (QoL), and satisfaction with homeopathic treatment were assessed prospectively for one year. Results: Ten patients were in the control group; 25 patients received adjunctive homeopathic treatment. The median number of self-reported UTI in the homeopathy group decreased significantly, whereas it remained unchanged in the control group. The domain incontinence impact of the KHQ improved significantly (P = 0.035), whereas the general QoL did not change. The satisfaction with homeopathic care was high. Conclusions: Adjunctive homeopathic treatment lead to a significant decrease of UTI in SCI patients. Therefore, classical homeopathy could be considered in SCI patients with recurrent UTI. Trial registration: ClinicalTrials.gov. (NCT01477502).

Treatment of Complicated Urinary Tract Infections in Individuals with Chronic Neurogenic Lower Urinary Tract Dysfunction: Are Antibiotics Mandatory?

INTRODUCTION: Urinary tract infections (UTI) in patients with neurogenic lower urinary tract dysfunction (NLUTD) are defined as complicated UTI requiring antibiotic treatment. As the emergence of multiresistant strains is a serious problem, we assessed the feasibility of nonantibiotic treatment of UTI in patients with NLUTD. MATERIALS AND METHODS: In a prospective study evaluating the usefulness of UTI prophylaxis, participants could opt for either antibiotic or nonantibiotic treatment of breakthrough UTI. If either symptoms persisted for 48 h or a febrile UTI occurred, antibiotic treatment based on microbiological testing was mandatory. Treatment efficacy, complications, and emergency hospital visits were assessed. RESULTS: Within the observation period (1 year), the 25 participants developed 206 UTI. Seven febrile UTI required immediate antibiotic treatment. Of the remaining 199 UTI, patients chose antibiotic treatment in 104 events, whereas in 95 events, patients chose either nonantibiotic interventions (n = 80) or no treatment at all (n = 15). Success rates were 78.8% for antibiotic treatment, 67.5% with nonantibiotic treatments, and 26% without therapy. Of the 7 patients with initially febrile UTI, 2 required hospitalization due to septicemia. CONCLUSIONS: Nonantibiotic treatment seems to be a feasible alternative to antibiotic therapy in patients with complicated UTI as well, provided there is no fever.

In Vitro Effects of Homeopathic Drugs on Cultured Escherichia coli.

BACKGROUND: Recurrent urinary tract infections (UTIs) are one of the most common morbidities in persons with neurogenic lower urinary tract dysfunction (NLUTD). Repetitive antibiotic treatment increases the risk of selecting multi-resistant bacteria. Homeopathic treatment has been reported to be effective in these patients. The mechanism of action, however, has not been clarified. Recently, a direct bactericidal effect of homeopathic remedies was shown. Such an effect is not in accordance with the general principles of homeopathy. To test this paradigm, we assessed the in vitro effects of homeopathic drugs on Escherichia coli derived from patients with NLUTD. METHODS: E. coli bacteria were harvested from 28 consecutive urine cultures. Standard antibiotic resistance testing and simultaneous resistance testing to homeopathic drugs (Apis mellifica, Cantharis, Causticum hahnemanni, Staphysagria, Nux vomica, Berberis vulgaris, and Lycopodiumclavatum) in high (C30) potency were performed. RESULTS: No significant inhibitory effect of any of the tested homeopathic drugs on any E. coli population could be found, irrespective of their sensitivity to antibiotic treatment. CONCLUSION: Based on our results, effects of homeopathic treatment of UTI are not based on direct bactericidal or bacteriostatic effects. These findings are in concordance with the hypothesis that homeopathy is based on host effects: for example, activation of the immune system, rather than effects on pathogens.