The study investigated the role of homeopathic medicines in daily treatment of uncomplicated (i.e., without need for an initial antibiotic prescription) acute otitis media (AOM). Recurrence rates and antibiotic prescriptions over 12 months were compared in patients initially prescribed either homeopathic medicines or medicines from one of three conventional therapeutic classes.

This exploratory cohort study used real-world electronic health care data from the Disease Analyzer database (IQVIA). German patients of all ages diagnosed with AOM between 2010 and 2018 who were prescribed either homeopathic, nasal, otological medicines or non-opioid analgesics on the day of diagnosis or within 6 days thereafter were included. AOM recurrence was assessed using multivariable logistic regression; the number of antibiotic prescriptions was assessed using multivariable negative binomial regression.

A total of 113,983 of 745,372 patients diagnosed with AOM were eligible for analysis. Of these, 9.9% of patients initially received prescriptions for homeopathic medicines. In the total patient group, these prescriptions were associated with a slightly reduced risk of AOM recurrence compared with otological medicines (odds ratio, 1.17; statistically significant, p = 0.011). All results of the negative binomial regression analysis of antibiotic prescriptions were in favor of homeopathic medicines. Those were statistically significant in the comparison versus otological medicines in all patients and in the adult sub-group. Time-to-event analysis for first antibiotic prescriptions showed statistically significantly reduced time-related risks in the homeopathy group compared with all groups of conventional medicines included (in all patients and in two pre-defined age-dependent sub-groups).

The real-world data analyzed in this study reveal that homeopathic medicines play a relevant role in daily AOM treatment as a stand-alone therapy class. Additionally, the study yielded important methodological findings on prescription patterns in routine AOM care in Germany, with specific focus on the role of homeopathic medicines.

The Disease Analyzer database is the property of IQVIA and is not publicly available.

All authors contributed to the design of the study and drafted, corrected, revised, and approved the manuscript.

Given certain conditions, German law allows the use of anonymized electronic medical data for research purposes. For observational studies without identifiable patient data, neither informed consent nor ethics committee approval is required. The authors never had access to identifiable patient data. Since the data were only used in aggregated form and no personal health information was reported, no ethical approval was required for the use of the Disease Analyzer database (IQVIA) and the conduct of the study.

Received: 26 June 2025

Accepted: 20 October 2025

Article published online:
12 March 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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