Dr Laila Ibrahim has been
awarded a full-time scholarship under Avant’s Doctor in Training Research
Scholarship Program 2015 to lead the world’s first randomised controlled trial
to explore the hypothesis that children with cellulitis can effectively and
safely be treated at home with antibiotics.
paediatric registrar and part-time Community and Child Health Fellow at The
Royal Children’s Hospital Melbourne, Dr Ibrahim’s passion for paediatrics
ignited when she first stepped onto a children’s ward while completing her
medical degree in Dublin.
“I thought ‘This is it – I would like to come
in and do this every day,’” she says.
Dr Ibrahim (pictured), 34, who
moved to Melbourne in 2012 with her husband, a neonatology fellow, after seeing
the ‘capital of cool’ advertised on TV, has forged a successful career as a
researcher, clinician and educator.
Benefits of treating
children at home
Dr Ibrahim will use the Avant scholarship to
complete the third stage of the CHOICE (Cellulitis: Home Or Inpatient in
Children from Emergency) project as part of her Doctor of Medical Science degree
at the University of Melbourne.
The idea for developing the
direct-from-emergency department-to-home pathway germinated while working as a
‘Hospital-In-The-Home’ (HITH) registrar at the Royal Children’s Hospital
Melbourne, she says.
“I would treat the children in their homes as
opposed to on the hospital ward, so I saw firsthand the advantages of treating a
child in their own bed,” she says.
“We know that children with chronic
health care needs treated at home have better psychological outcomes, are less
exposed to hospital-acquired infections, have less adverse events and there is
less disruption to family life. We believed this could be extrapolated to all
‘Bringing the hospital to the child’ vision to life
Expanding on the HITH concept, Dr Ibrahim was instrumental in the
formation of the CHOICE team involving key clinicians at The Royal Children’s
Hospital Melbourne. The experienced team includes her mentor, A/Prof Penelope
Bryant, Infectious Diseases Physician and Head of the HITH, Prof Nigel Curtis,
Head of Infectious Diseases, A/Prof Franz Babl, Director of Emergency Research,
Dr Sandy Hopper, an emergency physician and Dr Tom Connell, Director of General
Results from the first stage of the CHOICE project, a published
prospective observational study which Dr Ibrahim led comparing home IV
ceftriaxone versus standard treatment with inpatient IV flucloxacillin in 144
children with cellulitis has provided pilot data for the current trial. The
results were positive, showing that the duration of antibiotics (home
2.3 daysversus inpatient 2.5
days) and the length of stay (2.7 days in both groups) under medical care were similar in both treatment
As the principal investigator for the CHOICE trial, Dr Ibrahim
will compare the safety and efficacy of once daily home IV ceftriaxone versus
inpatient IV flucloxacillin in 188 children aged six months to 18 years who
present to The Royal Children’s Hospital’s emergency department with moderate to
“The primary outcome is lack of improvement within 48
hours which usually results in a change of antibiotics meaning that the children
would have to come into hospital,” she says.
Secondary outcomes include
readmission to hospital, adverse events, length of stay, economic evaluation of
cost effectiveness and patient/parent satisfaction.
A comparison of the
clinical effects of ceftriaxone and flucloxacillin on children’s gut microbiota
will also form a key component of the trial.
“In some situations
ceftriaxone has been associated with increased resistance in bacteria, so
providing conclusive evidence whether or not short-term use has this effect in
healthy children will be a significant finding,” Dr Ibrahim says.
Treatment of cellulitis is the tip of the iceberg
view to publishing the results in early 2017, Dr Ibrahim believes the research
will have significant practice implications.
"If this study
shows that once daily ceftriaxone at home is a safe and effective way to treat
moderate/severe cellulitis, the benefits in quality of life for children and
their families and cost effectiveness will lead to this becoming the standard
of care and change clinical practice,” she says.
However, Dr Ibrahim
says the use of home antibiotics for cellulitis is just the tip of iceberg, with
the research potentially having broader implications for the treatment of many
other common medical conditions.
undivided focus to increase research quality
Dr Ibrahim said
she was delighted to win the Avant Doctor in Training Research Scholarship as it
lends weight to her research and will allow her to focus on the research
“Having that external body support you gives so much
credibility to the research itself and to the researcher. I think having that
line on my CV that I’ve had support from Avant is going to go a long, long way,”
“The scholarship has also been crucial to allow me to focus
entirely on clinical and laboratory research for the tenure of my postgraduate
degree which will also increase the quality of the research.”
Does your research deserve funding?
Applications for the 2016
Avant Doctor in Training Research Scholarship Program are now open. Twenty-two
scholarships are available – more than any other year to date – worth $450,000,
for both emerging and experienced researchers.
Apply online on the Avant
website or for more
information download our Information Pack.
If you have any questions, please contact the DiT Research
Scholarship team at firstname.lastname@example.org. Applications close 31 May 2016.
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