Long-term Antibiotics for Treatment and Prevention of Otitis Media in Aborignal Children (COMIT1)
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Purpose
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.
| Condition | Intervention | Phase |
|---|---|---|
|
Otitis Media |
Drug: Amoxycillin Drug: Placebo equivalent to amoxycillin |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Amoxycillin Versus Placebo for Resolution of Otitis Media With Effusion and Prevention of Acute Otitis Media With Perforation in Aboriginal Infants: a Randomised Controlled Trial. |
- Proportion of children with middle ear effusion [ Time Frame: end of intervention ]
- Proportion of study visits at which middle ear effusion detected [ Time Frame: during intervention ]
- Proportion of infants with tympanic membrane perforation [ Time Frame: end of intervention ]
- Proportion of study visits with tympanic membrane perforation [ Time Frame: during intervention ]
- Proportion of infants with nasopharyngeal colonisation with resistant Streptococcus pneumoniae [ Time Frame: end of intervention ]
- proportion of infants withdrawn from study due to intervention adverse events [ Time Frame: end of intervention ]
| Enrollment: | 126 |
| Study Start Date: | April 1996 |
| Study Completion Date: | March 2001 |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: 1 |
Drug: Amoxycillin
50 mg/kg/day twice daily
|
| Placebo Comparator: 2 |
Drug: Placebo equivalent to amoxycillin
50 mg/kg/d twice daily
|
Eligibility| Ages Eligible for Study: | up to 12 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
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
Contacts and Locations| Australia, Northern Territory | |
| Menzies School of Health Research | |
| Darwin, Northern Territory, Australia, 0811 | |
| Principal Investigator: | John D Mathews, PhD, DSc. | Menzies School of Health Research and University of Melbourne |
More Information
Additional Information:
Publications:
| ClinicalTrials.gov Identifier: | NCT00539149 History of Changes |
| Other Study ID Numbers: | COMIT1, NHMRC 954086 |
| Study First Received: | October 2, 2007 |
| Last Updated: | May 21, 2010 |
| Health Authority: | Australia: National Health and Medical Research Council |
Keywords provided by Menzies School of Health Research:
|
Acute otitis media Otitis media with effusion Tympanic membrane perforation |
Additional relevant MeSH terms:
|
Otitis Otitis Media Otitis Media with Effusion Ear Diseases Otorhinolaryngologic Diseases |
Amoxicillin Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 13, 2013