Our research
We combine clinical studies, quality registry data, antimicrobial stewardship initiatives, and translational research to improve antibiotic use and preserve the effectiveness of existing antimicrobial agents.
We conduct clinical and registry-based studies of antibiotics recommended in national treatment guidelines, investigate factors contributing to antimicrobial resistance, and perform antibiotic stewardship audits at Oslo University Hospital (OUH) using data from the hospital’s Antibiotic Quality Registry.
Research goal
Our overall aim is to perform clinically relevant, patient-centered research on antibiotics and antimicrobial resistance while contributing to improved antimicrobial stewardship and evidence-based prescribing practices across clinical departments.
Projects
We have several ongoing projects.
GentaSafe - Safety and Effectiveness of Gentamicin in Sepsis
Gentamicin remains a key component of Norwegian treatment guidelines for severe bacterial infections and sepsis. However, concerns regarding nephrotoxicity have contributed to considerable variation in its clinical use.
In this project, we use data from the OUH Sepsis Registry to compare mortality and the incidence of acute kidney injury in patients receiving gentamicin-containing antibiotic regimens versus alternative broad-spectrum antibiotic strategies.
The MikroGenta pilot study - “Microbiome analysis of gentamicin treated patients
All antibiotic treatment affects the normal microbiota and may contribute to dysbiosis and selection of resistant microorganisms.
This pilot study investigates how gentamicin-based antibiotic regimens influence the gut and upper respiratory tract microbiota compared with broader-spectrum antibiotic treatment.
Using microbiome and resistome analyses, we evaluate the ecological consequences of antibiotic exposure and identify factors associated with resistance development.
Multidrug resistant bacterial infections in Ukranian patients
Since 2022, OUH has treated Ukrainian patients with war-related injuries, many of whom have experienced infections caused by multidrug-resistant (MDR) or extensively drug-resistant (XDR) bacteria.
This project investigates the epidemiology, microbiology, treatment strategies, and clinical outcomes of MDR/XDR bacterial infections in this patient population.
The study is conducted through close collaboration between the Departments of Orthopaedic Surgery, Clinical Microbiology, and Infectious Diseases at OUH.
The findings may provide important insights into the management of highly resistant infections in complex trauma patients.
Aminoglycosides in early sepsis (AGES)
AGES is a national pragmatic multicentre randomized study evaluating empiric treatment strategies for patients with suspected community-acquired sepsis.
The study compares narrow-spectrum beta-lactam antibiotics combined with aminoglycosides against more commonly used broad-spectrum antibiotic regimens. The primary endpoint is a composite outcome of acute kidney injury or death within 30 days after randomization.
By addressing a central dilemma in modern sepsis care, balancing antimicrobial stewardship against concerns regarding aminoglycoside toxicity, AGES aims to provide evidence that can guide future national and international treatment guidelines.
PIVOT study: Pivmecillinam as oral step-down for E. coli UTI
PIVOT is a Scandinavian multicentre clinical trial involving eleven hospitals in Sweden and two hospitals in Norway.
The study investigates whether oral pivmecillinam is non-inferior to standard oral antibiotic therapy as step-down treatment for urinary tract infections caused by Escherichia coli.
The trial is coordinated by Akademiska University Hospital and Uppsala University, Sweden, and seeks to strengthen the evidence base for narrow-spectrum antibiotic alternatives in the treatment of common bacterial infections.
Selected publications
- Fecal Microbiota Transplantation Versus Vancomycin for Primary Clostridioides difficile Infection: A Randomized Controlled Trial. Juul FE, Bretthauer M, Johnsen PH, Samy F, Tonby K, Berdal JE, Hoff DAL, Ofstad EH, Abraham A, Seip B, Wiig H, Rognstad ØB, Glad IF, Valeur J, Nissen-Lie AE, Ness-Jensen E, Lund KMA, Skjevling LK, Hanevik K, Skudal H, Melsom EJ, Boyar R, Cooper TJ, Ranheim TE, Riise EM, Adami HO, Kalager M, Løberg M, Garborg KK. Ann Intern Med. 2025 Jul;178(7):940-947. doi: 10.7326/ANNALS-24-03285. Epub 2025 Jun 17. PMID: 40523286
- Bruk-Spar-Reserve». Knudsen CV, Akselsen PE, Fostervold A, Gammelsrud KW, Haugan I, Husby A, Knudsen PK, Lindbæk M, Lindemann PC, Sundsfjord A, Tonby K. Tidsskr Nor Laegeforen. 2025 Jun 2;145(7).
- Clinical review Clostridioides difficile infection. Skåland MT, Tonby K, Ingebretsen A, Gammelsrud KW, Garborg KK, Juul FE Tidsskr Nor Legeforen 2025 Vol. 145Gentamicin should remain part of the empirical sepsis regimen for adults.
