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

The Swedish strategic programme against antibiotic resistance – Strama

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

Regional Strama groups play an important part in communicating data and results to prescribers in order to demonstrate development and decide on the focus of local 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 http://www.strama.se. The Strama work is characterized by a cyclical process with continuous communication with prescribers.

Local, national and international cooperation

The Public Health Agency of Sweden works for an interdisciplinary, locally approved model by ensuring involvement of all relevant stakeholders including national and local authorities and professional and non-profit organisations. In 2012, the Swedish intersectoral coordinating mechanism was formed, a forum of 20 government agencies active in efforts against antibiotic resistance to strengthen action in the field.

Joint international efforts are important. Sweden has 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.

Read more in the report Swedish work on containment of antibiotic resistance or read the report divided into six chapters.