Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Alastair Hay, University of Bristol,
- Second opponent: Professor Johan Håkon Bjørngaard, NTNU - Norwegian University of Science and Technology,
- Third member and chair of the evaluation committee: Professor Anne Kveim Lie, University of Oslo
Chair of the Defence
Associate professor Liv Augestad, University of Oslo
Principal Supervisor
Associate professor Anja Maria Lyche Brænd, University of Oslo
Summary
Acute sinusitis is one of the most common infections managed in general practice and a leading reason for antibiotic prescribing. Reducing unnecessary antibiotic use is a key public health priority due to the increasing threat of antimicrobial resistance.
The aims of this thesis were to examine trends in antibiotic prescribing for acute sinusitis and other respiratory tract infections in Norwegian general practice, to assess whether reduced prescribing was associated with increased rates of serious complications, and to evaluate the impact of antibiotic treatment on subsequent healthcare utilisation and sickness absence.
Three register-based studies were conducted using nationwide data from national health registries covering more than nine million respiratory tract infection episodes between 2012 and 2019.
Antibiotic prescribing for respiratory tract infections, including sinusitis, declined substantially over the study period, suggesting that national stewardship efforts translated into measurable change in clinical practice.
Severe complications following acute sinusitis were rare, and complication rates at the population level did not increase despite the marked reduction in antibiotic prescribing.
Antibiotic treatment was associated with only modest differences in subsequent healthcare use and sickness absence, indicating a limited downstream benefit of routine treatment.
Overall, the findings suggest that restrictive antibiotic prescribing for acute sinusitis is compatible with safe patient care, and provide real-world support for continued stewardship efforts in primary care.
Additional information
Contact the research support staff.