Experience in Germany suggests that Pelargonium sidoides extracts are safe, with 1 in 189,000 patients experiencing a side effect during an average treatment period of 10 days. A few reports of potential liver problems were found to relate to other causes. Honey was well tolerated in the studies, and is readily available. However, it should not be given to children under 1 year of age because of concerns about infant botulism. It also contains sugars, and the committee discussed concerns about tooth decay.

Children aged 6-12 years should take 5ml of the syrup three times a day (morning, midday, evening). In the last few years Pelargonium has gone from being an obscure herbal remedy to become one of Germany’s most popular herbal medicines. The committee agreed that because the evidence of benefit of doxycycline over amoxicillin, clarithromycin or erythromycin is limited, these antibiotics should be offered as alternative first choices. This also reflects concerns that doxycycline is contraindicated in pregnancy, and this should be considered when choosing antibiotics for women of childbearing age.They are listed below. Uncommon side-effects (affecting more than 1 in 1,000 but fewer than 1 in 100 people) Metlay JP, Kapoor WN, Fine MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA. 1997;278(17):1440-1445. Honey significantly reduced the frequency and severity of cough at 1 day follow-up compared with placebo, no treatment or an antihistamine (diphenhydramine) by about 0.5 to 2 points on a carer‑reported 7-point Likert scale in children and young people with an acute cough caused by an upper respiratory tract infection (low to moderate quality evidence). Carer responses about cough symptoms ranged from 'extremely' (6 points) to 'not at all' (0 points), but it was not clear how these responses were defined. A. Its syrup is non-drowsy and has been used to treat several respiratory infections; cough and cold are the most common ones. It does not make you sleepy or drowsy. Q. How do you grow pelargonium sidoides? It’s important to continue treatment for 3 days after symptoms have resolved to prevent a relapse. Pelargonium safety

The committee agreed that there was some evidence that suggests honey reduced cough symptoms in children and young people with an acute cough caused by an upper respiratory tract infection. The clinical significance of the benefit of honey on cough symptoms is unclear, particularly because follow-up was for 1 day only. Evans AT, Husain S, Durairaj L, Sadowski LS, Charles-Damte M, Wang Y. Azithromycin for acute bronchitis: a randomised, double-blind, controlled trial. Lancet. 2002;359(9318):1648-1654. Proposed mechanisms of virus-induced cough in patients with ARTI include effects on the airway epithelium such as cytokine release by inflamed epithelial cells associated with increased neurotransmitter and neural receptor levels and reduced activity of neutral endopeptidases, as well as effects on cholinergic motor pathways like bronchoconstriction and airway hyperresponsiveness caused by increased leukotriene production and mucus hypersecretion through superficial goblet cells and submucosal glands [ 6, 8, 9]. The committee discussed the evidence that inhaled corticosteroids reduced additional treatments being sought, and they could reduce the prescribing of antibiotics for acute cough. However, any prescribed alternatives to antibiotics have workload implications as people are likely to re‑consult and expect similar treatments in the future, sending the wrong message that prescribed treatment is needed for a largely self‑limiting condition. Pelargonium sidoides are known to exhibit antimicrobial properties. People apply its powdered plant material, soaked in water, as a face cream to treat skin acne. Pelargonium sidoides oils have antioxidant and anti-inflammatory properties, which naturally boost skin health and provide a healthy glow. In addition, they help condition the skin, soothe irritated skin and help fight against harsh weather conditions. 4. Helps Treat Stomach Ailments

Liver problems including hepatitis have been reported when taking this product. However, a causal relationship has not been established. The frequency is not known. After taking this product However, honey did not reduce the frequency and severity of cough at 1 day follow-up compared with an antitussive (dextromethorphan; very low quality evidence). In subgroup analysis by antibiotic, there was no significant difference in clinical improvement between doxycycline and placebo (3 RCTs), erythromycin and placebo (2 RCTs) or amoxicillin and placebo (2 RCTs; low to moderate quality evidence). However, cefuroxime significantly increased clinical improvement at follow-up in adults with acute bronchitis compared with placebo (1 RCT, n=343, 92.4% versus 79.1%; low quality evidence). If you have any questions, or are unsure about anything, please ask your doctor, pharmacist or healthcare practitioner. Possible side-effects

No studies on the effects on the ability to drive and use machines have been performed. 4.8 Undesirable effects Gastro-intestinal complaints such as stomach pain, heartburn, nausea, vomiting, difficulty swallowing (dysphagia) or diarrhoea. Rare side-effects (affecting more than 1 in 10,000 but fewer than 1 in 1000 people) Such reactions may occur when this product is first taken. Very rare side-effects (affecting 1 or fewer in 10,000 people)Honey significantly reduced bothersome cough by about 2 points on a 7‑point Likert scale compared with placebo (moderate quality evidence), but not compared with no treatment or dextromethorphan (low quality evidence). A study involving 105 people with bacterial sinusitis, in which symptoms had been present for at least one week, showed that taking Pelargonium extracts three times daily for up to 22 days produced significant improvements in symptoms, with faster recovery than those taking placebo, and no significant side effects. Pelargonium and tonsillitis If you get any side-effects, talk to your doctor, pharmacist or nurse. This includes any possible side-effects not listed in this leaflet. You can also report side-effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard. By reporting side-effects you can help provide more information on the safety of this medicine. How to store this product Cefuroxime is a broad-spectrum antibiotic (a second generation cephalosporin). The committee discussed that, if an antibiotic is needed to treat an infection that is not life-threatening, a narrow-spectrum antibiotic should generally be first choice. Indiscriminate use of broad-spectrum antibiotics creates a selective advantage for bacteria resistant even to these 'last-line' broad-spectrum agents, and also kills normal commensal flora leaving people susceptible to antibiotic-resistant harmful bacteria such as Clostridium difficile. Adult participants randomized to EPs 7630 (n=373) in trials D, E and F showed slightly less severe coughing at baseline than those in the placebo group (n=271; meta-analysis difference: 0.11 points; 95% CI: 0.00, 0.21 points).