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.
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 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
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.
Preventing Anxiety, Depression And Substance Use In Adolescents.
Funder
National Health and Medical Research Council
Funding Amount
$1,709,988.00
Summary
Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders. Yet we have few models of well-implemented prevention programs for these common disorders. The current proposal addresses this gap by evaluating an innovative internet-based approach to preventing mental health and substance use problems in Australian adolescents.
Tracking The Impact Of Drug Regulatory Actions: Consumer Health Outcomes, Risk-benefit Issues And Policy Framework.
Funder
National Health and Medical Research Council
Funding Amount
$439,324.00
Summary
This study will explore what happens in the community when a medicine is withdrawn from the market or discredited due to safety concerns. It will examine the impacts of two recent cases of medicine withdrawal or serious long-term safety concern, on a large cohort of women with high utilisation rates who were monitored during the time the medicines were discredited. The study will be an important guide to future regulatory, media and provider responses when medicines are discredited.
Parental Supply Of Alcohol To Children: Associations With Early Adult Health – “binge” Drinking, Alcohol-related Harms, Aggression, And Alcohol Use Disorders
Funder
National Health and Medical Research Council
Funding Amount
$1,143,477.00
Summary
We will investigate of the impacts of parental supply of alcohol between 13-18 years, on early adult alcohol use (19-23 years). We will follow an existing cohort of ~1,810 parent-child dyads, and assess the development of alcohol use, disorders, harms and aggression. We will investigate the impacts of: parental supply of sips vs drinks; supervised vs unsupervised supply; and modifying effects of contexts of supply and mediators (such as peer, child factors, etc.) controlling for confounders.
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.
Randomised Double-blind Placebo-controlled Study Of Lisdexamfetamine For The Treatment Of Methamphetamine Dependence
Funder
National Health and Medical Research Council
Funding Amount
$1,303,735.00
Summary
Addiction to methamphetamines (‘ice’) is a growing community problem linked to serious disease and death. Current counselling approaches have limited success on their own, and more effective treatments linked to medications are needed. Lisdexamfetamine is a newly licenced stimulant medication with great promise in treating these patients. This trial will examine whether lisdexamfetamine (with counselling) safely reduces methamphetamine use and improves health and wellbeing among heavy users.