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Finding a better treatment for ear disease

Finding a better treatment for ear disease: Azithromycin versus Amoxycillin for treatment of Acute Otitis Media in Aboriginal children (AATAAC)

Chronic suppurative otitis media (CSOM), or 'runny ears' is one of the most important health problems affecting young Aboriginal children in Australia today. Children with CSOM have significant hearing loss, which contributes to educational and social disadvantage.

CSOM has been a major public health issue for 25 years and the subject of numerous studies. Yet high rates of the disease persist. Medical management varies considerably among clinicians, and current treatment options are viewed to have poor outcomes. Past research has shown that CSOM can be prevented by successful treatment of acute otitis media (AOM), which is the precursor to CSOM. However, questions remain on the most effective way to treat AOM. The new pneumococcal conjugate vaccine is likely to reduce its incidence but many other bacteria can still cause AOM. Antibiotics will be required to treat these conditions.

The AATAAC project was completed in 2005 and assessed the effectiveness of a new antibiotic treatment option for AOM. The new treatment, involving a single dose of azithromycin, was compared with the current recommended treatment of seven days with the antibiotic amoxycillin.

Initiatives to simplify the treatment regime for acute otitis media are important. Single dose azithromycin has been shown to be effective in one overseas study, but its effectiveness in Aboriginal children with more severe cases of the disease needed to be tested. It was also be important to know if the bacteria become resistant to azithromycin.

Summary of project outcomes

High rates of treatment failure:

Is Azithromycin more effective than Amoxicillin?

Implications of findings for policy and practice:

Further research required:

Summary of project implementation

The project involved 16 Aboriginal communities throughout the Northern Territory, with a focus on Aboriginal children under six years of age, who were diagnosed either with acute otitis media without perforation (AOM/woP) or acute otitis media with perforation (AOM/wiP). Each community appointed a health clinic member to assist with the project.

Related resources:
Project leader

Peter Morris

Administering institution:

Menzies School of Health Research