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From random care to randomized clinical trials of patients with invasive streptococcal infections—research prioritisation and areas of equipoise

Life-threatening invasive infections caused by Streptococcus pyogenes and Streptococcus dysgalactiae subsp. equisimilis (SDSE) are unpredictable, frequently fatal, and are increasing in incidence globally. In the absence of evidence from randomized controlled trials (RCTs), clinical management for these conditions varies. Understanding current management approaches and areas of clinical equipoise will inform planning of feasible high-impact RCTs.

A whole of country analysis of antimicrobial stewardship resources, activities and barriers for children in Australian hospitals pre- and post COVID-19

We aimed to assess and identify any gaps in antimicrobial stewardship resources and activities for all hospitalised children in Australia pre- and post- the COVID-19 pandemic

Safety, tolerability, and pharmacokinetics of a 2 g subcutaneous dose of ceftriaxone as an alternative to intravenous delivery

Subcutaneous delivery of antibiotics is a practical alternative to intravenous administration. Ceftriaxone is commonly used for a variety of infections with limited data on the safety and pharmacokinetics of a 2 g subcutaneous dose. This was a prospective, self-controlled cross-over study in 20 stable inpatients receiving ceftriaxone for their infection. Following an intravenous dose, participants received a single dose of 2 g subcutaneous ceftriaxone, in 50 mL normal saline via gravity feed.

Establishing the lowest penicillin concentration to prevent pharyngitis due to Streptococcus pyogenes using a human challenge model (CHIPS)

The in-vivo plasma concentration of penicillin needed to prevent Streptococcus pyogenes pharyngitis, recurrent acute rheumatic fever, and progressive rheumatic heart disease is not known. We used a human challenge model to assess the minimum penicillin concentration required to prevent streptococcal pharyngitis.

The effect of comprehensive geriatric assessment on treatment decisions, supportive care received, and postoperative outcomes in older adults with cancer undergoing surgery

Surgery is an essential part of cancer treatment, particularly for localised solid tumours. Geriatric assessments (GA) with tailored interventions or comprehensive GA (CGA) can identify frailty factors and needs of older adults with cancer, assisting treatment decisions and care strategies to reduce postoperative complications. This systematic review summarises the effects of GA/CGA compared to usual care for older adults with cancer intended for surgery: their impact on treatment decisions, supportive care interventions, postoperative complications, survival, and health-related quality of life.

The need for community-controlled tools to monitor health impacts of housing and living conditions in Australia

We explore the contemporary landscape of housing investments and initiatives seeking to improve health outcomes among Aboriginal and Torres Strait Islander people in Australia, as well as the dearth of quality evidence and agreed approaches to evaluation.

Recovery of culturable Streptococcus pyogenes from swabs stored at different temperatures

Improving our understanding of superficial Streptococcus pyogenes (Strep A) carriage and transmission necessitates robust sampling methods. Here, we compared the effect of storing swab samples in fridge (+4°C) and freezer (-20°C) conditions on the recovery of laboratory-cultured S. pyogenes.

Subcutaneous Infusion of Benzathine Penicillin G Is Acceptable and Preferred Over Intramuscular Injections for Syphilis in Western Australian Sexual Health Clinic Attendees

Controlling the syphilis epidemic in Australia is a public health priority. Regular intramuscular (IM) injections of benzathine penicillin G (BPG) are the current standard of care for late latent syphilis in Australia; however, repeated IM BPG injections are painful, and treatment completion rates are low. Early-phase clinical trials have demonstrated the tolerability and safety of high-dose subcutaneous infusions of BPG (SCIP), where the total treatment dose can be delivered at a single visit. Here we describe the experiences and preferences of attendees of Western Australian sexual health clinics in the Perth metropolitan region who have syphilis and were treated with SCIP.

Berrembi Jarragboo-Boorroo Wajawoorroo Men'Gawoom Gijam (Gija Healthy Skin Story): Two-Way Learning for Healthy Skin

Remote-living Aboriginal children in Australia contend with higher rates of skin infections than non-Indigenous children. This work was embedded within a stepped-wedge, cluster randomised controlled trial aiming to halve the rate of skin infections in remote Kimberley communities. It outlines and reflects upon the co-development of a health promotion resource in partnership with the East Kimberley community of Warmun, whilst understanding community perceptions of its impact.