Long-term Antibiotics for Treatment and Prevention of Otitis Media in Aborignal Children

NCT ID: NCT00539149

Last Updated: 2010-05-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

126 participants

Study Classification

INTERVENTIONAL

Study Start Date

1996-04-30

Study Completion Date

2001-03-31

Brief Summary

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This clinical trial was conducted in a population where tympanic membrane perforation occurs in 60% infants in the first year of life. Nasopharyngeal colonisation (nasal contamination) with pathogenic bacteria occurs within weeks of life and predicts persistent middle ear infection throughout childhood. The trial aimed to assess whether twice daily antibiotics commencing at first detection of middle ear effusion would cure the infection and/or prevent disease progression, compared to placebo.

The study was conducted in three remote Aboriginal communities in the Northern Territory of Australia. The annual birth cohort was 45.

Aboriginal infants were seen as soon as possible after birth, and at 2 weekly intervals until middle ear effusion was detected by pneumatic otoscopy and tympanometry. Following consent, infants were randomised to either amoxycillin(50 mg/kg/d BD) or placebo equivalent for up to 24 weeks, or until normal middle ear status was detected at 2 consecutive monthly scheduled examinations. At monthly examinations the infant also had a general health check, parents were interviewed, child's medical record was reviewed, and nasopharyngeal swabs were collected.

Detailed Description

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Conditions

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Otitis Media

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1

Group Type ACTIVE_COMPARATOR

Amoxycillin

Intervention Type DRUG

50 mg/kg/day twice daily

2

Group Type PLACEBO_COMPARATOR

Placebo equivalent to amoxycillin

Intervention Type DRUG

50 mg/kg/d twice daily

Interventions

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Amoxycillin

50 mg/kg/day twice daily

Intervention Type DRUG

Placebo equivalent to amoxycillin

50 mg/kg/d twice daily

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Australian Aboriginal
* Living in participating remote community
* Less than 12 months of age

Exclusion Criteria

* Less than 32 weeks gestation
* Chronic condition requiring continuous antibiotic
* Ear, nose or throat abnormality
Maximum Eligible Age

12 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Health and Medical Research Council, Australia

OTHER

Sponsor Role collaborator

Menzies School of Health Research

OTHER

Sponsor Role lead

Principal Investigators

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John D Mathews, PhD, DSc.

Role: PRINCIPAL_INVESTIGATOR

Menzies School of Health Research and University of Melbourne

Locations

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Menzies School of Health Research

Darwin, Northern Territory, Australia

Site Status

Countries

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Australia

References

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Leach AJ, Morris PS. Antibiotics for the prevention of acute and chronic suppurative otitis media in children. Cochrane Database Syst Rev. 2006 Oct 18;2006(4):CD004401. doi: 10.1002/14651858.CD004401.pub2.

Reference Type BACKGROUND
PMID: 17054203 (View on PubMed)

Morris PS, Leach AJ, Halpin S, Mellon G, Gadil G, Wigger C, Mackenzie G, Wilson C, Gadil E, Torzillo P. An overview of acute otitis media in Australian Aboriginal children living in remote communities. Vaccine. 2007 Mar 22;25(13):2389-93. doi: 10.1016/j.vaccine.2006.09.006. Epub 2006 Sep 22.

Reference Type BACKGROUND
PMID: 17030497 (View on PubMed)

Morris PS, Leach AJ, Silberberg P, Mellon G, Wilson C, Hamilton E, Beissbarth J. Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey. BMC Pediatr. 2005 Jul 20;5:27. doi: 10.1186/1471-2431-5-27.

Reference Type BACKGROUND
PMID: 16033643 (View on PubMed)

Leach AJ, Morris PS. Perspectives on infective ear disease in indigenous Australian children. J Paediatr Child Health. 2001 Dec;37(6):529-30. doi: 10.1046/j.1440-1754.2001.00729.x.

Reference Type BACKGROUND
PMID: 11903828 (View on PubMed)

Coates HL, Morris PS, Leach AJ, Couzos S. Otitis media in Aboriginal children: tackling a major health problem. Med J Aust. 2002 Aug 19;177(4):177-8. doi: 10.5694/j.1326-5377.2002.tb04727.x. No abstract available.

Reference Type BACKGROUND
PMID: 12175319 (View on PubMed)

Leach AJ, Morris PS, Smith-Vaughan H, Mathews JD. In vivo penicillin MIC drift to extremely high resistance in Serotype 14 Streptococcus pneumoniae persistently colonizing the nasopharynx of an infant with chronic suppurative lung disease: a case study. Antimicrob Agents Chemother. 2002 Nov;46(11):3648-9. doi: 10.1128/AAC.46.11.3648-3649.2002.

Reference Type RESULT
PMID: 12384383 (View on PubMed)

Mulvaney CA, Galbraith K, Webster KE, Rana M, Connolly R, Marom T, Daniel M, Venekamp RP, Schilder AG, MacKeith S. Antibiotics for otitis media with effusion (OME) in children. Cochrane Database Syst Rev. 2023 Oct 23;10(10):CD015254. doi: 10.1002/14651858.CD015254.pub2.

Reference Type DERIVED
PMID: 37870130 (View on PubMed)

Other Identifiers

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NHMRC 954086

Identifier Type: -

Identifier Source: secondary_id

COMIT1

Identifier Type: -

Identifier Source: org_study_id

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