Investigation into the Effectiveness of an Herbal Combination (Angocin®Anti-Infekt N) in the Therapy of Acute Bronchitis: A Retrospective Real-World Cohort Study.

Background: The goal of this study was to evaluate whether the medical recommendation of Angocin^®Anti-Infekt N (heretofore referenced as Angocin^®) on the day of diagnosis of acute bronchitis is negatively associated with the recurrence of acute bronchitis diagnosis, antibiotic prescriptions, incidence of chronic bronchitis, and duration of sick leave.

Methods: This study included patients in general practices in Germany with a first documented diagnosis of acute bronchitis between 2005 and 2022 (index date) and a prescription of Angocin^®, thyme products, essential oils, mucolytics or antibiotics on the index date. The association between Angocin^® prescription and the risks of a relapse of acute bronchitis, development of chronic bronchitis, or subsequent antibiotic prescription were evaluated using Cox regression models. Univariable conditional logistic regression models were used to investigate the association between Angocin^® prescription and duration of sick leave.

Results: After a 1:5 propensity score matching, 598 Angocin^® patients and 2990 patients in each of the four comparison cohorts were available for analysis. Angocin^® prescription was associated with significantly lower incidence of a renewed confirmed diagnosis of acute bronchitis as compared to essential oils (Hazard ratio (HR): 0.61; 95% Confidence Interval (CI): 0.46-0.80), thyme products (HR: 0.70; 95% CI: 0.53-0.91), mucolytics (HR: 0.65; 95% CI: 0.49-0.85) or antibiotics (HR: 0.64; 95% CI: 0.49-0.84). Also, there were significantly lower incidences of subsequent re-prescriptions of antibiotics when compared to mucolytics (HR: 0.73; 95% CI: 0.53-0.99) or antibiotics (HR: 0.53; 95% CI: 0.39-0.72) and a significantly lower risk of chronic bronchitis as compared to essential oils (HR: 0.60; 95% CI: 0.46-0.78), thyme products (HR: 0.53; 95% CI: 0.41-0.69), mucolytics (HR: 0.49; 95% CI: 0.38-0.63) or antibiotics (HR: 0.59; 95% CI: 0.45-0.76).

Conclusions: Considering the limitations of the study, the results shed light on the sustaining effectiveness of Angocin^® prescription in the management of acute bronchitis and the associated outcomes when compared to several other treatments commonly used for this condition.