Amoxycillin for Persistent Nasal Discharge in Rural and Remote Aboriginal Children: A randomised controlled trial

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Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical trial will measure the impact of antibiotic treatment on persistent nasal discharge and rates of transmission of bacterial respiratory pathogens. An innovative study design will test the efficacy of twice daily doses of amoxycillin on newly developed clinical and bacteriological outcome measures. Both the investigators and the Aboriginal community have considerable experience in conducting this type of research and are committed to using a cooperative model of clinical research to reduce disease burden. Ongoing training of Aboriginal health workers in the principles of clinical epidemiology is an essential component of this process. This study will make an important contribution to the medical literature. Despite the deaths of around 10,000 children children from acute respiratory infections each day, very little is known about how antibiotics affect the transmission of some of the principal causative organisms. This project will greatly assist the development of appropriate antibiotic prescribing practices in high-risk populations.