Selective use of long-term antibiotics for chronic lung obstructive disease in Aboriginal adults: A multi-centre trial

选择性使用长期抗生素治疗原住民成人慢性肺阻塞性疾病：一项多中心试验

• 批准号: nhmrc : 236210
• 负责人: Prof Graeme Maguire
• 金额: $ 29.79万
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2003
• 资助国家: 澳大利亚
• 起止时间: 2003-01-01 至 2005-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/selective-use-long-centre-trial/99382
• 关键词: Selective; use; long; term; antibiotics

Indigenous Australians suffer from well-documented health disadvantage. This is demonstrated particularly for chronic obstructive lung disease (COPD-COAD). In remote communities nearly 15% of Aboriginal Australians suffer from COPD. This is reflected in death rates that show Aboriginal Australians as 6 times more likely to die from COPD and to be hospitalised much more frequently for this condition. Treatment options for COPD once it is established are however limited. Although smoking is a well recognised cause of COPD it is becoming clear that in Aboriginal Australians additional factors are likely to be important. Aboriginal Australians have higher rates of bacterial respiratory infections compared non-Indigenous Australians and it is likely that this is an important preventable factor in the establishment and progression of COPD. The aim of this study is thus to determine if the judicious use of regular antibiotics will be effective in treating Aboriginal adults with COPD. Particularly we aim to determine if this treatment can prevent acute exacerbations, which are associated with hospitalisation and death, and reduce inflammation in the airways, which is associated with continuing damage to the lungs and progressive disability. The involvement of 4 Aboriginal communities in this well-designed clinical trial is an important advance in the methods used to evaluate interventions in Aboriginal health. The project will also provide local training and equipment to improve the assessment and management of respiratory disease in remote Aboriginal communities. Finally the results of this study will be directly relevant to evidence-based guidelines that are currently utilised for the management of COPD in Aboriginal and Torres Strait Islander populations.

澳大利亚原住民的健康劣势得到了充分的证明。这一点在慢性阻塞性肺疾病(COPD-Coad)中尤为明显。在偏远社区，近15%的澳大利亚原住民患有慢性阻塞性肺病。这反映在死亡率上，这表明澳大利亚原住民死于慢性阻塞性肺病的可能性是后者的6倍，并因此而住院的频率要高得多。然而，一旦慢性阻塞性肺病确诊，其治疗选择是有限的。虽然吸烟是公认的慢性阻塞性肺疾病的原因，但越来越明显的是，在澳大利亚土著人中，其他因素可能是重要的。与非土著澳大利亚人相比，土著澳大利亚人的细菌呼吸道感染率更高，这很可能是慢性阻塞性肺病的建立和发展的一个重要的可预防因素。因此，这项研究的目的是确定在治疗患有慢性阻塞性肺疾病的土著成年人时，明智地使用常规抗生素是否有效。特别是，我们的目标是确定这种治疗是否可以防止与住院和死亡相关的急性恶化，并减少与肺部持续损害和进行性残疾相关的呼吸道炎症。4个土著社区参与了这项精心设计的临床试验，这是用于评估土著健康干预措施的方法的一个重要进步。该项目还将提供当地培训和设备，以改进偏远土著社区呼吸系统疾病的评估和管理。最后，这项研究的结果将与目前用于管理土著和托雷斯海峡岛民慢性阻塞性肺病的循证指南直接相关。