Judicious use of antibiotics for acute otitis media in Aboriginal children: A multi-centre clinical trial

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Aboriginal children living in remote communities have the highest rates of severe ear infections and associated hearing loss currently reported in the medical literature. In some rural and remote Aboriginal communities, all infants have their first infection by 3 months of age and up to 60% develop chronic suppurative otitis media (pus draining from the ears) in the first year of life. By the time they reach school-age more than 50% of children have a significant hearing loss. This has important implications for their education. The aim of this study is to determine whether a new longer-acting antibiotic will be more effective in treating young Aboriginal children with new ear infections and therefore prevent the progression to chronic suppurative otitis media. The involvement of up to 20 Aboriginal communities in this well-designed clinical trial represents a major advance in the methods used to evaluate interventions in Aboriginal health. The project will also provide training in ear examination and appropriate medical management. Swabs from the nose will be taken to monitor the effect of antibiotics on the rates of antibiotic resistance. The results from this study will be directly relevant to evidence-based guidelines on the management of otitis media in Aboriginal and Torres Strait Islander populations.