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

土著儿童的急性和慢性呼吸道疾病的发病率是有记录以来最高的。虽然根本原因是社会经济上的不利因素，但导致疾病的贫困特征尚不清楚。我们目前对过度拥挤、营养不良和烟雾暴露等重要风险因素的理解不能完全解释农村和偏远土著社区的过高发病率。这项随机、双盲、安慰剂对照的临床试验将衡量抗生素治疗对持续鼻分泌物和呼吸道细菌病原体传播率的影响。一项创新的研究设计将测试每天两次剂量的阿莫西林在新开发的临床和细菌学结果指标上的有效性。研究人员和原住民社区在进行这类研究方面都有相当的经验，并致力于利用临床研究的合作模式来减轻疾病负担。对土著卫生工作者进行临床流行病学原则方面的持续培训是这一进程的一个重要组成部分。这项研究将对医学文献做出重要贡献。尽管每天有大约10,000名儿童死于急性呼吸道感染，但人们对抗生素如何影响一些主要致病微生物的传播知之甚少。该项目将极大地帮助在高危人群中制定适当的抗生素处方做法。

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.