Use Of Molecular Resistance Assays To Provide Alterative Oral Treatment Strategies For Gonorrhoea In Indigenous And Other High-risk Populations; A Randomised Cluster Trial
Funder
National Health and Medical Research Council
Funding Amount
$828,671.00
Summary
Gonorrhoea has now developed resistance to almost all antibiotics that have been used to treat it. In this study, we will investigate a new treatment approach that selects antibiotics on a patient-by-patient basis. We will use new molecular assays to first test if a gonorrhoea strain infecting a patient is susceptible to an antibiotic, and will then treat on the basis of this result. By doing so, we will optimize our use of antibiotics and improve treatment strategies for gonorrhea.
Neisseria Gonorrhoeae Antmicrobial Resistance: Detection And Propagation
Funder
National Health and Medical Research Council
Funding Amount
$435,129.00
Summary
Neisseria gonorrhoeae, the pathogen that causes gonorrhoea, has developed resistance to multiple classes of antibiotics. The last remaining class of antibiotics that can successfully be used for general treatment of gonorrhoea is extended spectrum cephalosporins (ESCs). However, we are now starting to see Neisseria gonorrhoeae isolates with early signs of ESC resistance. This research will use molecular technology and mathematical modelling to investigate Neisseria gonorrhoeae antimicrobial resi ....Neisseria gonorrhoeae, the pathogen that causes gonorrhoea, has developed resistance to multiple classes of antibiotics. The last remaining class of antibiotics that can successfully be used for general treatment of gonorrhoea is extended spectrum cephalosporins (ESCs). However, we are now starting to see Neisseria gonorrhoeae isolates with early signs of ESC resistance. This research will use molecular technology and mathematical modelling to investigate Neisseria gonorrhoeae antimicrobial resistance in Australia.Read moreRead less
Horizontal And Vertical Transmission Mechanisms Of Staphylococcus Aureus Multiresistance Plasmids
Funder
National Health and Medical Research Council
Funding Amount
$408,993.00
Summary
Strains of Golden Staph bacteria resistant to many antibiotics are a major cause of serious hospital-acquired, and increasingly community-acquired, infections. The bacteria have mechanisms that cause efficient transmission of resistance genes to their offspring as well as to other strains. This project aims to elucidate key features of these mechanisms so that treatments can be devised that disrupt the maintenance and transfer of resistance, so as to prolong the effectiveness of antibiotics.
Treatment Of Acute Otitis Media (AOM) In Low Risk Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,640,326.00
Summary
A randomised clinical trial design will be used to compare two different approaches to the treatment of acute middle ear infections in Aboriginal children living in urban communities: initial observation or immediate antibiotic prescription. The relative acceptability and cost effectiveness of treatment options will be studied. The evidence will allow primary care clinicians to confidently recommend treatment that maximises health benefits and reduces complications such as hearing impairment.
A Randomised Controlled Trial Of Alternative Treatments To Intramuscular Penicillin For Impetigo In Aboriginal Children
Funder
National Health and Medical Research Council
Funding Amount
$1,326,182.00
Summary
We will conduct clinical trials to find an effective, simple and cheap oral alternative to injected penicillin for skin sores which could become the universal standard of care whether the patient is in Melbourne or Milingimbi. It would also likely be adopted by the World Health Organization as a standard of care for developing countries. This would lead directly to a reduced burden of skin sores and their complications. It would also open the way for studies to explore even simpler regimens.
A Randomised Placebo-controlled Trial Of Antibiotics To Prevent Urinary Tract Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$735,000.00
Summary
This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this ....This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this means the identification of children thought to be most at risk of recurrent UTI by renal tract imaging. Those found to have reflux of urine from the bladder to the kidney (present in about 30% of those with UTI) are then placed on antibiotics fro 2-5 years. Unfortunately there has never been a properly designed trial to test whether antibiotics do really prevent UTI and if so, whether children with reflux are the appropriate and only group requiring treatment. Long term antibiotics may in fact do more harm than good because of side effects like skin, bowel and blood problems and because resistant bacteria may develop. The design of this study involves the random allocation of placebo or antibiotic (cotrimoxazole, the usual antibiotic given in this case) to about 800 children after their first symptomatic UTI. These children are treated and followed for one year to determine the rate of futher UTI in both groups. Any difference in outcome between the two groups of children will be because of the antibiotic treatment. This study may prove long-term antibiotics are ineffective and therefore should not be routinely used. In this case investigation of children to detect vesicoureteric reflux would serve little purpose and should be abandoned. Alternatively antibiotic treatment may be shown as effective treatment for preventing further UTI and in this case the study will clearly identify those children who will benefit.Read moreRead less