First Practical Major Step toward Appropriate Antimicrobial Use by the Government of Japan.

Antimicrobial resistance (AMR) is one of the top public health agendas in Japan. Since Japan published the national action plan (NAP) on AMR in 2016, the NAP implementation has been a major focus in Japan Ministry of Health, Labour and Welfare (MHLW). Japan MHLW recently published the 1st edition of "Manual of Antimicrobial Stewardship" (including English version), a narrative review with particular focus on outpatient setting of primary care and two common infectious disease conditions. This is one of very few occasions where MHLW proactively set a clinical guidance for health care delivery at facility level. Implementation of the manual will be further supported by the change in our social health insurance coverage.