Antibiotic use for Australian Aboriginal children in three remote Northern Territory 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.

[1]  S. Tong,et al.  Correction: Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities , 2020, PloS one.

[2]  H. Leslie,et al.  Antibiotic exposure among children younger than 5 years in low-income and middle-income countries: a cross-sectional study of nationally representative facility-based and household-based surveys. , 2019, The Lancet. Infectious diseases.

[3]  L. Anderson,et al.  An urgent need for antimicrobial stewardship in Indigenous rural and remote primary health care , 2019, The Medical journal of Australia.

[4]  J. McVernon,et al.  High burden of infectious disease and antibiotic use in early life in Australian Aboriginal communities , 2019, Australian and New Zealand journal of public health.

[5]  D. Heymann,et al.  Community level antibiotic utilization in India and its comparison vis-à-vis European countries: Evidence from pharmaceutical sales data , 2018, PloS one.

[6]  N. Day,et al.  Retrospective review of the management of acute infections and the indications for antibiotic prescription in primary care in northern Thailand , 2018, BMJ Open.

[7]  F. Al-Yaman.  The Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people, 2011. , 2017, Public health research & practice.

[8]  A. Ponsonby,et al.  Prevalence and determinants of antibiotic exposure in infants: A population‐derived Australian birth cohort study , 2017, Journal of paediatrics and child health.

[9]  M. Karama,et al.  Prevalence, seasonal variation, and antibiotic resistance pattern of enteric bacterial pathogens among hospitalized diarrheic children in suburban regions of central Kenya , 2016, Tropical Medicine and Health.

[10]  G. Kang,et al.  Use of antibiotics in children younger than two years in eight countries: a prospective cohort study , 2016, Bulletin of the World Health Organization.

[11]  F. Stanley,et al.  Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study , 2016, PloS one.

[12]  E. Roughead,et al.  Prescribed antibiotic use in Australian children aged 0-12 years. , 2016, Australian family physician.

[13]  P. Bork,et al.  Intestinal microbiome is related to lifetime antibiotic use in Finnish pre-school children , 2016, Nature Communications.

[14]  J. Carapetis,et al.  Clinic Attendances during the First 12 Months of Life for Aboriginal Children in Five Remote Communities of Northern Australia , 2013, PloS one.

[15]  F. Mosca,et al.  Antibiotic use in infants in the first year of life in five European countries , 2012, Acta paediatrica.

[16]  J. Carapetis,et al.  Skin disease in the first two years of life in Aboriginal children in East Arnhem Land , 2011, The Australasian journal of dermatology.

[17]  Rustam I. Aminov,et al.  A Brief History of the Antibiotic Era: Lessons Learned and Challenges for the Future , 2010, Front. Microbio..

[18]  P. Morris,et al.  Otitis media in young Aboriginal children from remote communities in Northern and Central Australia : a cross-sectional survey , 2005 .

[19]  D. Pashen.  CARPA Standard Treatment Manual - A clinical manual for primary health care practitioners in remote and rural communities in Central and Northern Australia. 4th ed. , 2004 .

[20]  R. Murray.  Prescribing issues for Aboriginal people , 2003 .

[21]  P. Collignon.  11: Antibiotic resistance , 2002, The Medical journal of Australia.

[22]  F. Stanley,et al.  Hospital admissions before the age of 2 years in Western Australia. , 1994, Archives of disease in childhood.

[23]  M. Cecchini,et al.  ANTIMICROBIAL RESISTANCE IN G7 COUNTRIES AND BEYOND: Economic Issues, Policies and Options for Action , 2015 .

[24]  W. Witte,et al.  Antibiotic resistance. , 2013, International journal of medical microbiology : IJMM.

[25]  T. Wardlaw,et al.  Low birthweight: country regional and global estimates. , 2004 .

[26]  Tx Station.  Stata Statistical Software: Release 7. , 2001 .