The Scottish approach to enhancing antimicrobial stewardship.

In 2002, the Scottish Executive produced the Antimicrobial Resistance Strategy and Scottish Action Plan, which highlighted antimicrobial stewardship as a key objective in combating resistance. An important response, as a part of the Ministerial Healthcare Associated Infection Task Force work programme was the publication of 'Antimicrobial Prescribing Policy and Practice in Scotland: recommendations for good antimicrobial practice in acute hospitals' in 2005. This article briefly reviews the core components of the Scottish approach, reviews progress with some key goals and explores how many of these goals are being taken forward through a cohesive Scottish national multifaceted strategy, which incorporates primary and secondary care. Much of this will spring from the current review of the Scottish Action Plan. While recognizing the significant progress achieved by the Appropriate Antimicrobial Prescribing for Tomorrow's Doctors Project Group in the education of undergraduate medical students, the article also reviews the NHS Education Scotland-supported Scottish National Antimicrobial Prescribing Project, aimed at foundation training doctors in Scotland. We hope that this experience can be shared and further developed with colleagues within the United Kingdom and European Union.