Clinical Infections
Improving the diagnosis, investigation and treatment of children who present to hospital with common childhood illnesses
We focus on enhancing clinical care for childhood infections and other frequently encountered conditions, including approaches that support safe and effective management at home.
We bring together clinicians and researchers from general medicine, infectious diseases, palliative care and ambulatory services, with a strong focus on clinical and health services research that improves outcomes for children and families.
A key strength of our group is the breadth of our research interests and our strong collaborative culture. By working closely with clinicians across the campus, we translate research findings into real‑world practice to deliver better, evidence‑based care for patients.
Research streams
Clinical infections
The two major research questions that underlie the work we do are:
- How to optimise antibiotic use for childhood infections in children, both common (cellulitis, UTI) and specialised (infections in cancer)
- How to get sick kids out of hospital and back home
We know that by optimising antibiotic prescribing we can help get children home quicker, increase their quality of life, decrease costs for parents and the hospital and help reduce antimicrobial resistance, which is a current global crisis.
General paediatrics
General Medicine has the largest number of Advanced Trainees rotating through any department. A focus of researchers is the supervision and mentoring of trainees through their Royal Australasian College of Physicians (RACP) projects.
We aim to provide research governance and support to clinicians with ideas for smaller projects related to general paediatric patients to ensure high-quality research and outcomes that are translatable.
Group Leaders
Group Members
CHOICE UTI (Care at Home Or Inpatient in Children from Emergency with UTI)
CHOICE UTI is a world-first multi-centre clinical trial aiming to define a clinical guideline for antibiotic use in children with complicated UTI. Through this we hope to achieve our primary aims: get kids home quicker, optimise antibiotic use and reduce antimicrobial resistance.
Read more...
The Melbourne ASSET Score: Prospective Validation and Impact
The Melbourne ASSET score was designed to help clinicians decide whether to use intravenous or oral antibiotics for children with skin and soft tissue infections Skin infections are very common in children. In most cases, children can be treated with antibiotics taken by mouth but in some children, clinicians might choose to give antibiotics through a vein, known as IV or drip antibiotics.
Read more...Our projects
Vive La Resistance (VLR) Antimicrobial Resistance in Children
Antibiotics are usually very effective in treating infections. However, sometimes bacteria become resistant to antibiotics and much more difficult to treat - they become ‘Superbugs’. We want to find out what kinds of resistant bacteria are common among children living in Greater Melbourne and what factors make these bacteria either more or less likely to pop up
CHOICE UTI (Care at Home Or Inpatient in Children from Emergency with UTI)
Urinary tract infections (UTIs) are very common in children, with 3% having at least one in their childhood. Most cases are straightforward and can be managed with oral antibiotics, however, some children will experience complications. For these children, there are no clinical guidelines on antibiotic use which can lead to overprescribing, hospital stays and antimicrobial resistance.
CHOICE UTI is a multicentre clinical trial aiming to define a clinical guideline for antibiotic use in children with UTI. Through this we hope to achieve our primary aims; get kids home quicker, optimise antibiotic use and reduce antimicrobial resistance.
Optimising antibiotic use in Hospital-in-the-Home
We know home is the best place for children. Our research shows that recovery and quality of life are better at home. Therefore, one of our key drivers is how to get kids home more quickly or avoid hospital altogether. Some of our research questions to tackle this are:
- Can we safely send children home on antibiotics after complicated appendix surgery?
- Can we find ways to give antibiotics once daily rather than 2 or 3 times per day, making them easier to remember and more effective?
- Can we modify the way antibiotics are managed during their administration and therefore increase flexibility with prescribing?
- Can we give a constant 24-hour antibiotic infusion for children with cystic fibrosis over a shorter period to give kids a few hours off and help their quality of life?
HOMER: improving routing and scheduling to care for children at home
The Royal Children’s Hospital has the largest paediatric Hospital in the home (HITH)program (Wallaby Ward) in Australia. Since its onset, HITH has continued to grow and COVID has accelerated this growth. A major challenge for the HITH team is coordinating patient services with appropriate team members.
We are working with Curve Tomorrow to build an automated route and scheduling platform that will revolutionise this process and allow HITH to continue to deliver first-class health care to even more children.
ELSA-FN
The Early versus Late Stopping of Antibiotics in high-risk Febrile Neutropenia (ELSA-FN) is a joint project with the Centre for Health Analytics. It is a first of its kind to develop new ways doctors can use patient Electronic Medical Records to improve antibiotic prescribing and outcomes for oncology patients.
We hope not only to achieve our primary research goals but also to facilitate the use of the Electronic Medical Record for future research and help streamline the clinical practice.
Project Collaborations
Vive La Resistance
Antimicrobial resistance (AMR) is a global health crisis, but there are sizeable gaps in our understanding of which children carry resistant bacteria, how it develops, how it is spread among family members and the impacts on childhood infections and long-term health. To help us answer all these questions, so we can combat AMR, we are enrolling children who attend the emergency department and collecting swabs and risk information from them. This will allow us to map childhood resistance across Melbourne, investigate factors that influence its development, and investigate any impacts this may have on antibiotic usage.
This research is in collaboration with the Doherty Institute, the University of Melbourne Department of General Practice, and the South Australian Health and Medical Research Institute, with funding support from the Royal Children's Hospital Foundation.
Pre-surgical Changes to Operative Prophylaxis (Pre-ChOP)
Our previous research showed that the highest rate of inappropriate antibiotic prescribing was in surgical prophylaxis. Our aim is to improve the use of prophylactic antibiotics has been assessed in a broad range of high-frequency representative surgeries at The Royal Children's Hospital.
A guideline is being developed in collaboration with clinical teams, to be implemented through the Electronic Medical Record. The goal is to standardise operative prophylaxis to decrease inappropriate use in the fight against antibiotic resistance. This research is in collaboration with the Centre for Health Analytics, with funding support from the Royal Children's Hospital Foundation.
Funding
- Medical Research Future Fund (MRFF)
- National Health and Medical Research Council (NHMRC)
- Royal Children's Hospital Foundation
- Department of Health and Human Services Victoria
Collaborations
- Royal Children's Hospital Emergency Department
- Hospital-in-the-Home program
- Centre for Health Analytics
- Curve Tomorrow
Key publications
Cost-effectiveness of home-based care of febrile neutropenia in children with cancer. 2021
Inpatient versus outpatient parenteral antibiotic therapy at home for acute infections in children: a systematic review. 2018