Antimicrobial Academy for Aboriginal and Torres Strait Islander Health Care Providers

Antibiotics to treat infections are the most commonly prescribed medicine in remote Australian Aboriginal and Torres Strait Islander communities. This high level of prescription is needed to treat the common, serious infections that are well reported in the north. However, the downside to antibiotic prescribing, is that bacteria may develop mechanisms that stop the antibiotic from working. This is called antibiotic resistance and is a really big problem in remote Australia. For example, skin infections caused by golden staph have a one in two chance of being resistant to the standard antibiotics. Worse still, if the golden staph enters the blood stream via the skin causing sepsis, it is critical that the right antibiotic is selected as quickly as possible to prevent death from sepsis.

The HOT NORTH Antimicrobial Academy will be a 6-month program for 6 Aboriginal or Torres Strait Islander health care workers (preferentially pharmacists, doctors, nurses or Aboriginal Health Workers embedded in clinical care in the north) interested in upskilling in antibiotic use, audit, stewardship, surveillance, and resistance. Candidate nominations to participate will come from interested health care organisations who support the candidate to develop skills and implement change in their organization. Fostering Aboriginal and Torres Strait Islander colleagues with these skillsets will be critical for safe prescribing, improved stewardship and advocacy to ensure that remote living Aboriginal and Torres Strait Islander Australians are included in national efforts to address antimicrobial use and resistance.

The translation outputs include:

1. Embedding the antimicrobial stewardship audit into routine care;
2. Training in surveillance skills to collect, understand and use antimicrobial resistance data through the HOTSpots platform;
3. Advocacy for AMR issues affecting Aboriginal and Torres Strait Islander people to policy makers and the National AMR Strategy.
4. Publication of surveillance findings;
5. Future use of the curriculum developed for the Academy as an ongoing training and education package.
6. Foundation for an NHMRC Partnership grant to continue to grow the capacity for high quality antimicrobial data.

Antimicrobial resistance (AMR) is a critical risk, affecting Australia’s remote living Aboriginal and Torres Strait Islander families at some of the highest reported rates in the country. HOT NORTH has made this as one of the five key themes of the research program, which aligns with the attention given globally to this issue. The World Health Organisation declared AMR as one of the biggest health threats, with up to 10 million lives lost by 2050, extreme poverty for 24 million by 2030 and billions of dollars in health care costs and lost productivity for the global economy.

Through our HOT NORTH Pilot grant, we have collaborated across the North and piloted an antimicrobial stewardship audit. This is the first-time tools developed through our partner, the National Centre for Antimicrobial Stewardship (NCAS) have been implemented in the remote Aboriginal and Torres Strait Islander primary health care sector. Implementation of this audit and advocacy on behalf of this sector has revealed a gap in knowledge, expertise and skills for Aboriginal and Torres Strait Islander Australian health care providers around antimicrobial stewardship, resistance and surveillance. The HOT NORTH Antimicrobial Academy provides a meaningful opportunity to transfer skills from urban Australia to northern Australia and create a cadre of Aboriginal and Torres Strait Islander antimicrobial users, advocates and spokespeople to partner with and continue to improve health care delivery, research platforms and advocacy.

The HOT NORTH HOTSpots project is an essential tool to better understand local antimicrobial resistance for specific pathogens. Translation of this into primary care will be accelerated through this HOT NORTH Academy as Academy participants will be encouraged to develop questions that can be answered with surveillance tools. Together the mentoring teams and local mentees will then develop activities (education and resources) to guide improvement