An Epidemiological Study on the Effectiveness of Nasturtium Herb and Horseradish Root (Angocin® Anti-Infekt N) as well as Other Phytopharmaceuticals, Synthetic Products, and Antibiotics on the Course of Acute Upper Respiratory Tract Infection (aURTI)

Background: The goal of this study was to evaluate whether medical recommendation of Angocin® Anti-Infekt N (hereafter referred to as Angocin®) on the day of diagnosis of an acute upper respiratory tract infection (aURTI) or acute sinusitis (AS) is negatively associated with a recurrence of these diagnoses, incidence of antibiotic prescriptions, incidence of chronic sinusitis, nasal polyps, or sick leave duration. Methods: This retrospective cohort study utilized the IQVIATM Disease Analyzer database and included patients by general practitioners with at least one diagnosis of aURTI or AS from 2005 to 2024 and a prescription of Angocin®, nasal medications (xylometazoline, oxymetazoline) and mucolytics (ambroxol or acetylcysteine), other phytopharmaceutical drugs, or antibiotics on the day of diagnosis. Patients who received Angocin® were matched separately to each of the three comparison cohorts in a 1:5 ratio using a nearest-neighbor propensity score approach. The relationship between Angocin® prescription and the risks of a recurrence, subsequent antibiotic use or progression to chronic disease was then estimated with Cox proportional hazard models. To examine whether Angocin® exposure was associated with the length of sick leave, univariable conditional logistic regression was applied. Results: A total of 3501 Angocin® patients and 17,505 patients in each further cohort were investigated. Angocin® prescription was associated with a significantly lower incidence of a newly diagnosed aURTI/AS as compared to other phytopharmaceuticals (Hazard ratio (HR): 0.78; 95% confidence interval (CI): 0.68–0.86), nasal medications and mucolytics (HR: 0.79; 95% CI: 0.71–0.88), or antibiotics (HR: 0.85; 95% CI: 0.77–0.95). In addition, there was a significantly lower incidence of subsequent further prescriptions of antibiotics when compared to other phytopharmaceuticals (HR: 0.92; 95% CI: 0.82–0.99), nasal medications and mucolytics (HR: 0.87 (95%; CI: 0.80–0.95), or antibiotics (HR: 0.62; 95% CI: 0.57–0.67). Furthermore, Angocin® was associated with the most advantageous pattern of work absence across all time periods examined. Conclusions: Considering the limitations of the study, the results cast a positive light on Angocin® prescription in the management of aURTI/AS, particularly with regard to recurrence rates, subsequent antibiotic prescriptions, and sick leave duration.