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.