Abstract Increasing use of antibiotics and rising levels of bacterial resistance to antibiotics are a challenge to global health and development.
Successful initiatives for containing the problem need to be communicated and disseminated. In Sweden, a rapid spread of resistant
pneumococci in the southern part of the country triggered the formation of the Swedish strategic programme against antibiotic resistance,
also known as Strama, in 1995. The creation of the programme was an important starting point for long-term coordinated efforts to tackle
antibiotic resistance in the country. This paper describes the main strategies of the programme: committed work at the local and national
levels; monitoring of antibiotic use for informed decision-making; a national target for antibiotic prescriptions; surveillance of antibiotic
resistance for local, national and global action; tracking resistance trends; infection control to limit spread of resistance; and communication
to raise awareness for action and behavioural change. A key element for achieving long-term changes has been the bottom-up approach,
including working closely with prescribers at the local level. The work described here and the lessons learnt could inform countries
implementing their own national action plans against antibiotic resistance.

• Qualitative data - Qualitative data were used during the intervention

• Human - All activities regarding organisations and individuals involved in health products and services

• Healthcare delivery