Infection

NOTICE: This health information was not created by the University of Michigan Health System (UMHS) and may not necessarily reflect specific UMHS practices. For medical advice relating to your personal condition, please consult your doctor. Complete disclaimer

Infection

Need to Know

Infection
Protect your body from infection—the invasion of microorganisms. The best defense? A strong immune system. According to research or other evidence, the following self-care steps may be helpful.
  • See a healthcare provider

    Except for common infections such as a cold, see your provider for help determining the cause and best treatment for your infection

  • Take a multivitamin

    Extra vitamins and minerals daily may help prevent deficiencies that increase your chances of getting an infection

  • Reduce stress

    Work with a counselor or with tapes and other self-help tools to reduce stress, which can impair your immune system

About

About This Condition

Infection is the result of invasion of the body by microorganisms, including bacteria, viruses, or fungi.

Not all microorganisms cause infections in the body, and exposure to a disease-causing microorganism does not always result in symptoms. The immune system plays a large role in determining the body’s ability to fight off infection.

Some examples of infection are common cold/sore throat, influenza, cough, recurrent ear infections, urinary tract infection, yeast infection, athlete’s foot, cold sores, HIV, shingles, and parasites.

Symptoms

Symptoms of infection include localized warmth, redness, swelling, discharge, foul-smelling odor, and pain to the touch. In more serious cases, symptoms may also include fever, chills, nausea, vomiting, diarrhea, and fatigue.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why Get started
Balance nutrition Nutrition contributes to proper immune system function, so support it by restricting sugar, drinking alcohol moderately or not at all, and eating less fat.

Balance nutrition

Nutrition is a major contributor to the functioning of the immune system, which in turn influences whether or not the body is resistant to infection. Specifically, it makes sense to restrict sugar, because sugar interferes with the ability of white blood cells to destroy bacteria.1 Alcohol also interferes with a wide variety of immune defenses,2 and excessive dietary fat reduces natural killer cell activity.3 However, there is no research investigating whether reducing sugar, alcohol, or fat intake decreases the risk of infection or improves healing.
Uncover your allergies Food allergies can play a role in recurrent infections. An elimination diet may help you discover sensitivities.

Uncover your allergies

Allergy , including food allergy, has been suggested to predispose people to recurrent infection,4 and many doctors consider allergy treatment for people with recurrent infections. The links between allergy and ear infections,5 , 6 urinary tract infections in children,7 and yeast vaginitis in women8 , 9 have been documented.

Supplements

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.


Supplement Amount Why
Andrographis
 48 to 60 mg andrographolides in two to three divided doses per day 3 stars   Andrographis supports the immune system and protects against microbes.

3 stars  Andrographis

48 to 60 mg andrographolides in two to three divided doses per day

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Double-blind trials have shown that common cold symptoms improve10 , 11 and recovery is faster12 when andrographis extract containing 48 to 60 mg andrographolides is taken in three or four divided doses daily, beginning as soon as possible after symptoms appear. In addition, preliminary research in Russia suggests andrographis extract may be effective for the treatment of influenza.13 This extract was also tested for preventing colds in a double-blind study of teenagers.14 After three months, the group taking 5 mg of andrographolides twice daily had only half the number of colds experienced by the placebo group.

Other preliminary15 and double-blind16 , 17 research has shown similar benefits for treating the common cold from a combination of andrographis extract and an eleuthero extract containing 2.0 to 2.4 mg per day eleutherosides.


Supplement Amount Why
Vitamin A
 See a doctor for evaluation of possible deficiency 3 stars   Vitamin A plays an important role in immune system function and helps mucous membranes, including those in the lungs, resist invasion by microorganisms.


3 stars  Vitamin A

See a doctor for evaluation of possible deficiency

Nutrients useful for maintaining healthy immune function are also applicable for preventing infections. Vitamin A plays an important role in immune system function and helps mucous membranes, including those in the lungs, resist invasion by microorganisms.18 However, most research shows that while vitamin A supplementation helps people prevent or treat infections in developing countries where deficiencies are common,19 little to no positive effect, and even slight adverse effects, have resulted from giving vitamin A supplements to people in countries where most people consume adequate amounts of vitamin A.20 , 21 , 22 , 23 , 24 , 25 , 26 Moreover, vitamin A supplementation during infections appears beneficial only in certain diseases. An analysis of trials revealed that vitamin A reduces mortality from measles and diarrhea, but not from pneumonia, in children living in developing countries.27 A double-blind trial for vitamin A supplementation in Tanzanian children with pneumonia confirmed its lack of effectiveness for this condition.28 In general, parents in the developed world should not give vitamin A supplements to children unless there is a reason to believe vitamin A deficiency is likely, such as the presence of a condition causing malabsorption (e.g., celiac disease). However, the American Academy of Pediatrics recommends that all children with measles should be given high-dose vitamin A for several days.

Supplement Amount Why
Vitamin C
 1 to 4 grams daily 3 stars   Vitamin C has antiviral activity, and may help prevent viral infections or, in the case of the common cold, reduce the severity and duration of an infection.


3 stars  Vitamin C

1 to 4 grams daily

Vitamin C has antiviral activity, and may help prevent viral infections29 or, in the case of the common cold, reduce the severity and duration of an infection.30 Most studies on the common cold used 1 to 4 grams of vitamin C per day.


Supplement Amount Why
Echinacea
 3 to 5 ml of liquid herbal extracts every two hours, or 300 to 600 mg of powdered herb three times per day, or 5 to 6 cups of tea daily 2 stars   Echinacea is both immune supportive and antimicrobial.

2 stars  Echinacea

3 to 5 ml of liquid herbal extracts every two hours, or 300 to 600 mg of powdered herb three times per day, or 5 to 6 cups of tea daily

Herbs that support a person’s immune system in the fight against microbes and directly attack microbes include the following: barberry, echinacea, elderberry, goldenseal, licorice, Oregon grape, osha, and wild indigo.

Supplement Amount Why
Multivitamin
(Type 2 Diabetes)
 Follow label instructions 2 stars   Supplementing with a multivitamin–mineral may give your body the nutrients it needs to help prevent common infections.

2 stars  Multivitamin

Follow label instructions

In a double-blind study, supplementation of middle-aged and elderly diabetics with a multiple vitamin and mineral preparation for one year reduced the risk of infection by more than 80%, compared with a placebo.31

Supplement Amount Why
Probiotics
 Consult a qualified healthcare practitioner 2 stars   Lactobacillus acidophilus produces acids that kill invading bacteria. These and other probiotics inhibit the growth of potentially infectious organisms and have been shown to be effective against some infections.

2 stars  Probiotics

Consult a qualified healthcare practitioner

Lactobacillus acidophilus (the friendly bacteria found in yogurt) produces acids that kill invading bacteria.32 The effective amount of acidophilus depends on the strain used, as well as the concentration of viable organisms. These and other friendly bacteria known as probiotics inhibit the growth of potentially infectious organisms (pathogens) by producing acids, hydrogen peroxide, and natural antibiotics called bacteriocins and microcins, by utilizing nutrients needed by pathogens, by occupying attachment sites on the gut wall that would otherwise be available to pathogens, and by stimulating immune attacks on pathogens. Infections that have been successfully prevented or treated with friendly bacteria include infectious diarrhea, vaginitis, and urinary tract infections.33 , 34

Supplement Amount Why
Selenium
(Very Low Birth Weight Infants)
 5 to 7 mcg per 2.2 lbs (1 kg) of body weight 2 stars   Premature infants with very low birth weight have an increased susceptibility to infections. In one trial, selenium supplements appeared to reduce hospital-acquired infections.

2 stars  Selenium

5 to 7 mcg per 2.2 lbs (1 kg) of body weight

Premature infants with very low birth weight have an increased susceptibility to infections. In a double-blind trial, premature infants were given either selenium supplements (5 to 7 mcg per 2.2 pounds of body weight) or placebo. Those receiving the selenium supplements had fewer hospital-acquired infections.35

Supplement Amount Why
Zinc
 Refer to label instructions 2 stars   Zinc deficiencies can impair immune function. Supplementing with zinc has been shown to increase immune function in healthy people. Zinc lozenges have been found helpful in against the common cold.


2 stars  Zinc

Marginal deficiencies of zinc result in immune function impairments.36 In a double-blind study of healthy elderly people, supplementing with 45 mg of zinc per day for one year significantly reduced the frequency of infections.37 Some doctors recommend lower amounts of supplemental zinc for people experiencing recurrent infections, such as 25 mg per day for adults and even lower amounts for children (depending on body weight). Zinc lozenges have been found helpful in some studies for the common cold. Long-term zinc supplementation should in most cases be accompanied by a copper supplement in order to prevent zinc-induced copper deficiency.


Supplement Amount Why
American Ginseng
 Refer to label instructions 1 star   American ginseng supports the immune system and protects against microbes.

1 star  American Ginseng

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Asian Ginseng
 Refer to label instructions 1 star   Asian ginseng supports the immune system and protects against microbes.

1 star  Asian Ginseng

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Astragalus
 Refer to label instructions 1 star   Astragalus supports the immune system and protects against microbes.

1 star  Astragalus

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Barberry
 Refer to label instructions 1 star   Barberry is both immune supportive and antimicrobial.

1 star  Barberry

Herbs that support a person’s immune system in the fight against microbes and directly attack microbes include the following: barberry, echinacea, elderberry, goldenseal, licorice, Oregon grape, osha, and wild indigo.

Supplement Amount Why
Chaparral
 Refer to label instructions 1 star   Chaparral is an herb that directly attack microbes.

1 star  Chaparral

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Coriolus versicolor
 Refer to label instructions 1 star   Coriolus supports the immune system and protects against microbes.
Elderberry
 Refer to label instructions 1 star   Elderberry is both immune supportive and antimicrobial.

1 star  Elderberry

Herbs that support a person’s immune system in the fight against microbes and directly attack microbes include the following: barberry, echinacea, elderberry, goldenseal, licorice, Oregon grape, osha, and wild indigo.

Supplement Amount Why
Eleuthero
 Refer to label instructions 1 star   Eleuthero supports the immune system and protects against microbes.

1 star  Eleuthero

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Double-blind trials have shown that common cold symptoms improve38 , 39 and recovery is faster40 when andrographis extract containing 48 to 60 mg andrographolides is taken in three or four divided doses daily, beginning as soon as possible after symptoms appear. In addition, preliminary research in Russia suggests andrographis extract may be effective for the treatment of influenza.41 This extract was also tested for preventing colds in a double-blind study of teenagers.42 After three months, the group taking 5 mg of andrographolides twice daily had only half the number of colds experienced by the placebo group.

Other preliminary43 and double-blind44 , 45 research has shown similar benefits for treating the common cold from a combination of andrographis extract and an eleuthero extract containing 2.0 to 2.4 mg per day eleutherosides.


Supplement Amount Why
Eucalyptus
 Refer to label instructions 1 star   Eucalyptus is an herb that directly attack microbes.

1 star  Eucalyptus

Caution: Do not use eucalyptus oil internally without supervision by a healthcare professional. As little as 3.5 ml of the oil taken internally has proven fatal.

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Garlic
 Refer to label instructions 1 star   Garlic is an herb that directly attack microbes.

1 star  Garlic

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Goldenseal
 Refer to label instructions 1 star   Goldenseal is both immune supportive and antimicrobial.

1 star  Goldenseal

Herbs that support a person’s immune system in the fight against microbes and directly attack microbes include the following: barberry, echinacea, elderberry, goldenseal, licorice, Oregon grape, osha, and wild indigo.

Supplement Amount Why
Green Tea
 Refer to label instructions 1 star   Green tea is an herb that directly attack microbes.

1 star  Green Tea

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Lemon Balm
 Refer to label instructions 1 star   Lemon balm is an antiviral and antimicrobial herb.

1 star  Lemon Balm

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Ligustrum
 Refer to label instructions 1 star   Ligustrum supports the immune system and protects against microbes.

1 star  Ligustrum

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Lomatium
 Refer to label instructions 1 star   Lomatium is an herb that directly attack microbes.

1 star  Lomatium

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Maitake
 Refer to label instructions 1 star   Maitake supports the immune system and protects against microbes.

1 star  Maitake

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Myrrh
 Refer to label instructions 1 star   Myrrh is an herb that directly attack microbes.

1 star  Myrrh

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Olive Leaf
 Refer to label instructions 1 star   Olive leaf is an herb that directly attack microbes.

1 star  Olive Leaf

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Onion
 Refer to label instructions 1 star   Onion is an herb that directly attack microbes.

1 star  Onion

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Oregano
 Refer to label instructions 1 star   Oregano is an herb that directly attack microbes.

1 star  Oregano

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Oregon Grape
 Refer to label instructions 1 star   Oregon grape is both immune supportive and antimicrobial.

1 star  Oregon Grape

Herbs that support a person’s immune system in the fight against microbes and directly attack microbes include the following: barberry, echinacea, elderberry, goldenseal, licorice, Oregon grape, osha, and wild indigo.

Supplement Amount Why
Osha
 Refer to label instructions 1 star   Osha is both immune supportive and antimicrobial.

1 star  Osha

Herbs that support a person’s immune system in the fight against microbes and directly attack microbes include the following: barberry, echinacea, elderberry, goldenseal, licorice, Oregon grape, osha, and wild indigo.

Supplement Amount Why
Pau d’Arco
 Refer to label instructions 1 star   Pau d’Arco is an herb that directly fights both microbes and fungus.

1 star  Pau d’Arco

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Picrorhiza
 Refer to label instructions 1 star   Picrorhiza supports the immune system and protects against microbes.

1 star  Picrorhiza

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Reishi
 Refer to label instructions 1 star   Reishi supports the immune system in the fight against microbes.

1 star  Reishi

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Rosemary
 Refer to label instructions 1 star   Rosemary is an herb that directly attack microbes.

1 star  Rosemary

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Sage
 Refer to label instructions 1 star   Sage is an herb that directly attack microbes.

1 star  Sage

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Sandalwood
 Refer to label instructions 1 star   Sandalwood is an herb that directly attack microbes.

1 star  Sandalwood

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Schisandra
 Refer to label instructions 1 star   Schisandra supports the immune system and protects against microbes.

1 star  Schisandra

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
Shiitake
 Refer to label instructions 1 star   Shiitake supports the immune system and protects against microbes.

1 star  Shiitake

Herbs that support a person’s immune system in the fight against microbes include the following: American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake.

Supplement Amount Why
St. John’s Wort
 Refer to label instructions 1 star   St. John’s wort is an herb that directly attack microbes.

1 star  St. John’s Wort

Caution: It is likely that there are many drug interactions with St. John's wort that have not yet been identified. St. John's wort stimulates a drug-metabolizing enzyme (cytochrome P450 3A4) that metabolizes at least 50% of the drugs on the market.46 Therefore, it could potentially cause a number of drug interactions that have not yet been reported. People taking any medication should consult with a doctor or pharmacist before taking St. John's wort.

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Tea Tree
 Refer to label instructions 1 star   Tea tree is an herb that directly attack microbes.

1 star  Tea Tree

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Thyme
 Refer to label instructions 1 star   Thyme is an herb that directly attack microbes.

1 star  Thyme

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Usnea
 Refer to label instructions 1 star   Usnea is an herb that directly attack microbes.

1 star  Usnea

Herbs that directly attack microbes include the following: chaparral, eucalyptus, garlic, green tea, lemon balm (antiviral), lomatium, myrrh, olive leaf, onion, oregano, pau d’arco (antifungal), rosemary, sage, sandalwood, St. John’s wort, tea tree oil, thyme, and usnea.

Supplement Amount Why
Wild Indigo
 Refer to label instructions 1 star   Wild indigo is both immune supportive and antimicrobial.

1 star  Wild Indigo

Herbs that support a person’s immune system in the fight against microbes and directly attack microbes include the following: barberry, echinacea, elderberry, goldenseal, licorice, Oregon grape, osha, and wild indigo.

References

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11. Hancke J, Burgos R, Caceres D, et al. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in the recovery from common colds. Phytother Res 1995;9:559–62.

12. Melchior J, Palm S, Wikman G. Controlled clinical study of standardized Andrographis paniculata extract in common cold-a pilot trial. Phytomedicine 1996;34:315–18.

13. Kulichenko LL, Kireyeva LV, Malyshkina EN, Wikman GA. Randomized, controlled study of Kan Jang versus amantadine in the treatment of influenza in Volgograd. J Herb Pharmacother 2003;3:77–93.

14. Caceres DD, Hancke JL, Burgos RA, et al. Prevention of common colds with Andrographis paniculata dried extract: a pilot double blind trial. Phytomedicine 1997;4:101–104.

15. Spasov AA, Ostrovskij, OV, Chernikov MV, Wikman G. Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang and an Echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children. Phytother Res 2004;18:47–53.

16. Melchior J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine 2000;7(5):341–50.

17. Gabrielian ES, Shukarian AK, Goukasova GI, et al. A double blind, placebo-controlled study of Andrographis paniculata fixed combination Kan Jang in the treatment of acute upper respiratory tract infections including sinusitis. Phytomedicine 2002;9:589–97.

18. Semba RD. Vitamin A, immunity, and infection. Clin Infect Dis 1994;19:489–99 [review].

19. Glasziou PP, Mackerras DEM. Vitamin A supplementation in infectious diseases: a meta-analysis. BMJ 1993;306:366–70.

20. Stephensen CB, Franchi LM, Hernandez H, et al. Adverse effects of high-dose vitamin A supplements in children hospitalized with pneumonia. Pediatrics 1998;101(5):E3 [abstract].

21. Bresee JS, Fischer M, Dowell SF, et al. Vitamin A therapy for children with respiratory syncytial virus infection: a multicenter trial in the United States. Pediatr Infect Dis J 1996;15:777–82.

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