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Swedish strategic programme (Strama) against AMR has decreased antibiotic prescriptions

Swedish strategic programme against antibiotic resistance (Strama), a nationwide structured and continuously evolving collaboration against antibiotic resistance has been in place since 1995. Levels of antibiotic use and resistance in Sweden are now among the lowest among EU both in the human and animal sectors. New report summaries that between 1992 and 2016, the number of prescriptions per 1000 inhabitants per year in outpatient care, including primary health care, decreased by 43%. Adherence to treatment recommendations has been increasing gradually and notably sales of antibiotics used for respiratory tract infections have also decreased.

Key element for achieving long-term changes has been the bottom-up approach, which including working closely with prescribers at the local level. Treatment guidelines are not just imposed from above, but are anchored in the clinical experience of the region. Good guidelines need to include diagnostic criteria, assessments of risks and benefits, give clear advice on how to use antibiotics and monitor actual prescription rates.

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