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Published on: April 28, 2014
Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities
Timothy Howarth1, Raelene Brunette2, Tanya Davies3
1Child Health, Menzies School of Health Research, Darwin, Northern Territory, Australia.
Insights
Antibiotic prescription rates for Australian Aboriginal children under two years old in remote Northern Territory communities are high. Most prescriptions aligned with guidelines, despite a high rate of infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Antibiotic resistance is a growing global concern.
- Understanding antibiotic prescribing patterns in remote Indigenous communities is crucial for targeted interventions.
Purpose of the Study:
- To determine antibiotic prescription rates in Australian Aboriginal children under two years old.
- To identify factors associated with antibiotic prescriptions and their appropriateness.
Main Methods:
- Retrospective cohort study utilizing electronic health records from three remote Northern Territory primary health care centers.
- Data extracted from 124 child records (born 2010-2014) with at least two years of electronic health records.
Main Results:
- A total of 1,330 antibiotic prescriptions were recorded across 5,675 primary health care encounters for 124 children.
- The prescription rate was 5.99 per person-year, significantly higher than national rates for non-Aboriginal children.
- Acute otitis media was the most common infection, and amoxicillin the most frequent antibiotic prescribed. 27% of prescriptions lacked a recorded infection, and 8% were not aligned with guidelines.
Conclusions:
- Antibiotic prescription rates are notably high in this population compared to national averages.
- Prescriptions largely followed treatment guidelines, reflecting the high burden of infectious diseases in these remote communities.
Objective:
To describe antibiotic prescription rates for Australian Aboriginal children aged <2 years living in three remote Northern Territory communities.
Design:
A retrospective cohort study using electronic health records.
Setting:
Three primary health care centres located in the Katherine East region.
Participants:
Consent was obtained from 149 mothers to extract data from 196 child records. There were 124 children born between January 2010 and July 2014 who resided in one of the three chosen communities and had electronic health records for their first two years of life.
Main Outcome Measures:
Antibiotic prescription rates, factors associated with antibiotic prescription and factors associated with appropriate antibiotic prescription.
Results:
There were 5,675 Primary Health Care (PHC) encounters for 124 children (median 41, IQR 25.5, 64). Of the 5,675 PHC encounters, 1,542 (27%) recorded at least one infection (total 1,777) and 1,330 (23%) had at least one antibiotic prescription recorded (total 1,468). Children had a median five (IQR 2, 9) prescriptions in both their first and second year of life, with a prescription rate of 5.99/person year (95% CI 5.35, 6.63). Acute otitis media was the most common infection (683 records, 38%) and Amoxycillin was the most commonly prescribed antibiotic (797 prescriptions, 54%). Of the 1,468 recorded prescriptions, 398 (27%) had no infection recorded and 116 (8%) with an infection recorded were not aligned with local treatment guidelines.
Conclusion:
Prescription rates for Australian Aboriginal children in these communities are significantly higher than that reported nationally for non-Aboriginal Australians. Prescriptions predominantly aligned with treatment guidelines in this setting where there is a high burden of infectious disease.
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