• Antibacterial use by birth year and birth season in children 0-2 years in Norway 

      Beckstrøm, Sanna; Svendsen, Kristian; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-08-16)
      Introduction: Consumption of antibacterials in children follows seasonal cycles, and time to first treatment depends on birth season. The aim of this study was to describe dispensing rate, one-year periodic prevalence, and age at first prescription in children aged 0-2 years in Norway. Methods: We used data from the Norwegian prescription database and included all dispensed prescriptions on systemic ...
    • Antibiotics to outpatients in Norway—Assessing effect of latitude and municipality population size using quantile regression in a cross-sectional study. 

      Haugen, Pål; Simonsen, Gunnar Skov; Primicerio, Raul; Furberg, Anne-Sofie; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-09-29)
      High antibiotic consumption rates are associated to high prevalence of antimicrobial resistance. Geographical differences in dispensing rates of antibiotics are frequently analysed using statistical methods addressing the central tendency of the data. Yet, examining extreme quantiles may be of equal or greater interest if the problem relates to the extremes of consumption rates, as is the case for ...
    • Association of area-level education with the regional growth trajectories of rates of antibacterial dispensing to patients under 3 years in Norway: a longitudinal retrospective study 

      Svalestuen, Sigbjørn; Svendsen, Kristian; Eggen, Anne Elise; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-09-08)
      Objective To examine the association between area-level education and the local growth trajectories in antibacterial dispensing rates in Norwegian municipalities among children under 3 years old.<p> <p>Design Retrospective, longitudinal study using individual primary care prescription data from the Norwegian Prescription Database for the period 2006–2016. Data were collected on the date of ...
    • An audit and feedback intervention study increased adherence to antibiotic prescribing guidelines at a Norwegian hospital 

      Høgli, June Utnes; Garcia, Beate Hennie; Skjold, frode; Skogen, Vegard; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2016-02-27)
      Background:<br> Appropriate antibiotic prescribing is associated with favourable levels of antimicrobial resistance (AMR) and clinical outcomes. Most intervention studies on antibiotic prescribing originate from settings with high level of AMR. In a Norwegian hospital setting with low level of AMR, the literature on interventions for promoting guideline-recommended antibiotic prescribing in ...
    • Changes in the consumption of antiepileptics and psychotropic medicines after starting low dose naltrexone: A nation-wide register-based controlled before-after study 

      Raknes, Guttorm; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2019-10-21)
      In this controlled before-after study based on data from the Norwegian Prescription Database, we examine whether starting off-label use of Low Dose Naltrexone (LDN) is followed by changes in the consumption of psychotropic medicines including antiepileptics. Patients that collected LDN for the first time in 2013 (N = 11247) were included and stratified into three groups based on LDN exposure. We ...
    • Circulating sex-steroids and Staphylococcus aureus nasal carriage in a general female population 

      Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert; Sollid, Johanna U Ericson; Simonsen, Gunnar Skov; Almås, Bjørg; Furberg, Anne-Sofie (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-02)
      <p>Objective: <i>Staphylococcus aureus</i> is a major human pathogen, and nasal carriers have an increased risk for infection and disease. The exploration of host determinants for nasal carriage is relevant to decrease infection burden. Former studies demonstrate lower carriage prevalence in women and among users of progestin-only contraceptives. The aim of this study was to investigate the possible ...
    • Circulating sex-steroids and Staphylococcus aureus nasal carriage in a general male population 

      Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert; Ericson, Johanna U; Simonsen, Gunnar Skov; Almås, Bjørg; Furberg, Anne Sofie (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-04-22)
      Male sex is associated with higher risk of both colonisation and infection with Staphylococcus aureus (S. aureus). However, the role of sex-steroids in colonisation among men is largely unknown. Thus, the aim of this study was to investigate possible associations between circulating sex-steroids and nasal carriage of S. aureus in a general male population. The population-based Tromsø6 study (2007–2008) ...
    • Community carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae: a cross-sectional study of risk factors and comparative genomics of carriage and clinical isolates 

      Raffelsberger, Niclas Peter; Buczek, Dorota Julia; Svendsen, Kristian; Småbrekke, Lars; Pöntinen, Anna Kaarina; Löhr, Iren Høyland; Andreassen, Lotte Leonore Eivindsdatter; Simonsen, Gunnar Skov; Sundsfjord, Arnfinn Ståle; Gravningen, Kirsten; Samuelsen, Ørjan (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-06-12)
      The global prevalence of infections caused by extended-spectrum βlactamase-producing Enterobacterales (ESBL-E) is increasing, and for Escherichia coli, observations indicate that this is partly driven by community-onset cases. The ESBL-E population structure in the community is scarcely described, and data on risk factors for carriage are conflicting. Here, we report the prevalence and population ...
    • Consumption of antibacterial agents : pharmacoepidemiology, resistance and interventions 

      Småbrekke, Lars (Doctoral thesis; Doktorgradsavhandling, 2009-09-03)
      Det overordnede målet med prosjektene som inngår i avhandlingen har vært å bidra til mer kunnskap om rasjonell bruk av antibiotika. Prosjektene er gjennomførte i allmennpraksis, og i sykehus i henholdsvis Norge, Danmark, Island og Sverige. <br>Det første delprosjektet undersøkte vi om det var mulig å endre forskrivning av antibiotika ved akutt mellomørebetennelse hos barn som kom til en legevakt. ...
    • The effect of low-dose naltrexone on medication in inflammatory bowel disease: A quasi experimental before-and-after prescription database study 

      Raknes, Guttorm; Simonsen, Pia; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2018-01-27)
      Background and Aims: Low-dose naltrexone [LDN] is a controversial off-label treatment used by many Crohn’s disease [CD] and ulcerative colitis [UC] patients. A small number of preliminary studies indicate that LDN might be beneficial in CD, but evidence is too scarce to demonstrate efficacy. We sought to examine whether initiation of LDN therapy by patients with inflammatory bowel disease [IBD] ...
    • Efficacy of mecillinam against clinical multidrug-resistant Escherichia coli in a murine urinary tract infection model 

      Zykov, Ilya Nikolaevich; Frimodt-Møller, Niels; Småbrekke, Lars; Sundsfjord, Arnfinn; Samuelsen, Ørjan (Journal article; Tidsskriftartikkel; Peer reviewed, 2019-11-23)
      Pivmecillinam, a pro-drug of mecillinam, has been used extensively in Scandinavia for the treatment of acute lower urinary tract infections (UTIs) caused by Enterobacterales. It is still an attractive first-line drug for the empirical treatment of UTIs owing to the low prevalence of resistance as well as its favourable impact on the intestinal microbiota as a pro-drug and good in vitro efficacy ...
    • Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study 

      Høgli, June Utnes; Garcia, Beate Hennie; Svendsen, Kristian; Skogen, Vegard; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2020-06-15)
      <i>Background</i> - Norwegian guideline recommendations on first-line empirical antibiotic prescribing in hospitalised patients with community-acquired pneumonia (CAP) are penicillin G/V in monotherapy, or penicillin G in combination with gentamicin (or cefotaxime) in severely ill patients. The aim of this study was to explore how different empirical antibiotic treatments impact on length of hospital ...
    • Exploring stakeholders' perspectives on the quality of services provided through community pharmacies 

      Jakobsen, Ann Helen; Småbrekke, Lars; Chen, Timothy F.; Halvorsen, Kjell H. (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-06-02)
      Introduction - It is important to understand the factors impacting the quality of services provided through community pharmacies. Exploring how key stakeholders perceive good quality in these services is a logical first step. This could also inform the development of quality measures, such as quality indicators (QIs).<p> <p>Aim - To identify key stakeholders' perspectives on the quality of services ...
    • Gastrointestinal carriage of Klebsiella pneumoniae in a general adult population: a cross-sectional study of risk factors and bacterial genomic diversity 

      Raffelsberger, Niclas Peter; Hetland, Marit Andrea Klokkhammer; Svendsen, Kristian; Småbrekke, Lars; Löhr, Iren Høyland; Andreassen, Lotte; Brisse, Sylvain; Holt, Kathryn E.; Sundsfjord, Arnfinn; Samuelsen, Ørjan; Gravningen, Kirsten Midttun (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-06-28)
      Antibiotic resistant <i>Klebsiella pneumoniae</i> is a leading public health threat and gastrointestinal carriage is an established risk factor for subsequent infections during hospitalization. Our study contributes new knowledge of risk factors for gastrointestinal carriage and the genomic population structure of <i>K. pneumoniae</i> colonizing humans in a representative sample of a general population ...
    • Hormonal contraceptive use and Staphylococcus aureus nasal and throat carriage in a Norwegian youth population 

      Stensen, Dina Benedicte Berg; Småbrekke, Lars; Olsen, Karina; Grimnes, Guri; Nielsen, Christopher Sivert; Simonsen, Gunnar Skov; Sollid, Johanna U. E.; Furgberg, Anne-Sofie (Journal article; Tidsskriftartikkel; Peer reviewed, 2019-07-05)
      <i>Background</i>: Use of hormonal contraceptives has been associated with <i>Staphylococcus aureus</i> nasal carriage in adult women. However, the role of hormonal contraceptives in S. aureus colonization among adolescents and associations with progestin only contraceptives are unknown.<p> <p><i>Methods</i>: We obtained nasal and throat swab samples from 439 girls aged 17–21 years in the ...
    • Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (The IMMENSE study) – a randomized controlled trial 

      Johansen, Jeanette Schultz; Halvorsen, Kjell H.; Svendsen, Kristian; Havnes, Kjerstin; Robinson, Eirin Guldsten; Wetting, Hilde Ljones; Haustreis, Stine; Småbrekke, Lars; Kamycheva, Elena; Garcia, Beate Hennie (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-10-26)
      <b><p>Background</b> Suboptimal medication use contributes to a substantial proportion of hospitalizations and emergency department visits in older adults. We designed a clinical pharmacist intervention to optimize medication therapy in older hospitalized patients. Based on the integrated medicine management (IMM) model, the 5-step IMMENSE intervention comprise medication reconciliation, medication ...
    • Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (The IMMENSE study) – a randomized controlled trial 

      Johansen, Jeanette Schultz; Halvorsen, Kjell H.; Svendsen, Kristian; Havnes, Kjerstin; Robinson, Eirin Guldsten; Ljones Wetting, Hilde; Haustreis, Stine; Småbrekke, Lars; Kamycheva, Elena; Garcia, Beate Hennie (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-10-26)
      Background - Suboptimal medication use contributes to a substantial proportion of hospitalizations and emergency department visits in older adults. We designed a clinical pharmacist intervention to optimize medication therapy in older hospitalized patients. Based on the integrated medicine management (IMM) model, the 5-step IMMENSE intervention comprise medication reconciliation, medication review, ...
    • Internet Use for Obtaining Medicine Information: Cross-sectional Survey 

      Bergmo, Trine Strand; Sandsdalen, Vilde; Manskow, Unn Sollid; Småbrekke, Lars; Waaseth, Marit (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-06-22)
      Background: The internet is increasingly being used as a source of medicine-related information. People want information to facilitate decision-making and self-management, and they tend to prefer the internet for ease of access. However, it is widely acknowledged that the quality of web-based information varies. Poor interpretation of medicine information can lead to anxiety and poor adherence to ...
    • Knowledge, attitudes and practices related to self-medication with antimicrobials in Lilongwe, Malawi 

      Sambakunsi, Cecilia S.; Småbrekke, Lars; Varga, Christine A.; Solomon, Vernon; Mponda, John S. (Journal article; Tidsskriftartikkel; Peer reviewed, 2019-12)
      <i>Background</i> - The use of antimicrobials is associated with the emergence of antimicrobial resistance (AMR), and self-medication increases the risk of the inappropriate use of antimicrobials. This study aims to describe the knowledge, attitudes, and practices (KAP) regarding self-medication with antimicrobials among residents in Lilongwe, Malawi.<p><p> <i>Methodology</i> - This study has ...
    • Low dose naltrexone in multiple sclerosis: Effects on medication use. A quasi-experimental study 

      Raknes, Guttorm; Småbrekke, Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-11-03)
      Low dose naltrexone (LDN) has become a popular off-label therapy for multiple sclerosis (MS). A few small, randomized studies indicate that LDN may have beneficial effects in MS and other autoimmune diseases. If proven efficacious, it would be a cheap and safe alternative to the expensive treatments currently recommended for MS. We investigated whether a sudden increase in LDN use in Norway in 2013 ...