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
Predicting the diagnostic performance of individuals and organisations. Predicting the diagnostic performance of individuals and organisations. This project aims to address diagnostic error in advanced technology systems, by providing a mechanism to assess and improve individual diagnosticians’ performance. Organisations that rely on their employees’ diagnostic skills rarely assess them once the operators become qualified, so there is no basis for interventions that might prevent diagnostic erro ....Predicting the diagnostic performance of individuals and organisations. Predicting the diagnostic performance of individuals and organisations. This project aims to address diagnostic error in advanced technology systems, by providing a mechanism to assess and improve individual diagnosticians’ performance. Organisations that rely on their employees’ diagnostic skills rarely assess them once the operators become qualified, so there is no basis for interventions that might prevent diagnostic errors affecting thousands. This research tests a new method of assessing diagnostic skills based on how skilled operators respond to cues. This project will test how employees’ diagnostic skills change and whether this change corresponds to measures of organisational performance. This research is expected to provide organisations with a tool to pre-empt diagnostic errors that could minimise costs to the economy.Read moreRead less
Adverse effects of sopite syndrome on occupants in wind-excited buildings. Current building motion design guidelines focus primarily on motion perception and complaint rates. However, wind-induced building motion can cause sopite syndrome or early onset motion sickness which adversely affects occupant wellbeing and work performance. This research aims to advance the understanding of the physiology of sopite syndrome, quantify the motion dosage that causes sopite syndrome and determine its advers ....Adverse effects of sopite syndrome on occupants in wind-excited buildings. Current building motion design guidelines focus primarily on motion perception and complaint rates. However, wind-induced building motion can cause sopite syndrome or early onset motion sickness which adversely affects occupant wellbeing and work performance. This research aims to advance the understanding of the physiology of sopite syndrome, quantify the motion dosage that causes sopite syndrome and determine its adverse effects on building occupants in real-world motion environments. This knowledge is expected to guide the formulation of building motion acceptability criteria based on safe motion exposure duration to facilitate the design of tall building that promotes population health and wellbeing and lifts work performance and productivity.Read moreRead less