Swedish work on containment of antibiotic resistance

Sweden has a relatively low use of antibiotics per capita and a comparatively favourable situation with regard to antibiotic resistance. Antibiotic consumption in Sweden has decreased substantially since the mid-1990s. The current situation is influenced by different factors including a long tradition of evidence-based guidelines and strong local commitment as well as strategic work on both regional and national level.

Early response to increasing antibiotic resistance in the mid-1990's led to the initiation of long-term and structured measures from the profession and authorities, and is one important explanation to why Sweden has been able to slow the escalation of antibiotic resistance. Part of the strategy was to implement treatment recommendations for common infections in outpatient care, resulting in a sustained decrease in antibiotic consumption.

A one health approach to AMR containment – the Swedish journey

The film presents how Sweden works with antibiotic resistance from a One Health perspective today. It also wants to show the incredible journey Sweden has made as a country over the past 150 years and how that development has been the basis for how we work with antibiotic resistance and the favorable resistance situation we have today.

The Swedish strategic programme against antibiotic resistance – Strama

Political support and commitment for the work on antibiotic resistance is strong and many stakeholders are involved on local and national level. Strama (the Swedish strategic programme against antibiotic resistance), founded in 1995, plays a central role and is now an advisory body to the Public Health Agency of Sweden.

Regional Strama groups play an important part in communicating local data on antibiotic consumption to prescribers, in order to follow development of prescribing and inform local stewardship interventions.

Networking and interaction are key elements in the Strama work: from the early identification of a problem, through analysis of possible interventions, to implementation and follow-up. The Strama groups also share their experiences at recurrent Strama days and through the web portal www.strama.se. The Strama work is characterized by a cyclical process with continuous communication with prescribers.


Infection prevention and control is another corner stone in the containment of antibiotic resistance. Regional Strama groups and regional infection prevention and control groups collaborate closely, and there is integration between work streams in antibiotic resistance, infection prevention and control, and healthcare-associated infections at the national level.

Local, national and international cooperation

The Public Health Agency of Sweden works through an interdisciplinary, locally endorsed model by ensuring involvement of all relevant stakeholders including national and local authorities, and professional and non-profit organisations. The Swedish intersectoral coordinating mechanism was formed in 2012 – a forum of 25 governmental agencies and organisations active in efforts to strengthen actions against antibiotic resistance.

As joint international efforts are important in combating antibiotic resistance, Sweden has developed several bilateral collaborations and is actively involved in global efforts to contain antibiotic resistance through cooperation with actors in other countries, the EU and the WHO.

International collaborations on antibiotic resistance