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

生活在偏远社区的土著儿童目前在医学文献中报告的严重耳朵感染和相关听力损失的比率最高。在一些农村和偏远的土著社区，所有婴儿在3个月大时都会首次感染，高达60%的婴儿在出生后第一年就会发展为慢性化脓性中耳炎(从耳朵流出脓液)。到他们达到学龄儿童年龄时，超过50%的儿童已经严重听力损失。这对他们的教育有重要的影响。这项研究的目的是确定一种新的长效抗生素在治疗患有新的耳部感染的年轻土著儿童方面是否会更有效，从而防止进展为慢性化脓性中耳炎。多达20个土著社区参与了这项精心设计的临床试验，这标志着用于评估土著健康干预措施的方法取得了重大进展。该项目还将提供耳朵检查和适当的医疗管理方面的培训。将从鼻子上取拭子来监测抗生素对抗生素耐药率的影响。这项研究的结果将与土著和托雷斯海峡岛民中耳炎管理的循证指南直接相关。

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.