Sweden
#00275
Implements
#00373 Establish antimicrobial stewardship teams with prescribing audit and feedback
Implementer
Swedish strategic programme against antibiotic resistance (Strama)
Location
Description
Sweden established Strama in 1995 as a national and regional collaboration for rational antibiotic use. Regional groups combine local treatment recommendations, surveillance, professional education, prescribing feedback and engagement with clinicians. The programme is embedded across all 21 regions rather than operating as a short-term awareness campaign. Outpatient antibiotic prescriptions fell from 560 per 1,000 inhabitants in 1992 to 256 in 2025. Nine of Sweden's 21 regions met the national target of no more than 250 prescriptions per 1,000 inhabitants in 2025.
Metrics
3Lessons learned
- Long-term regional stewardship relationships can change prescribing more durably than one-off awareness campaigns.
- National goals work best when local teams can adapt guidance and feedback to their own prescribing data.
- Observed national resistance trends reflect multiple interventions, so stewardship impact should not be overstated.
- Low antibiotic use does not eliminate resistance risk. Sweden's 2025 surveillance found rising reported cases of several notifiable resistant bacteria, supporting continued stewardship and infection prevention.
Sources
3