Core Elements of Hospital Antibiotic Stewardship Programs

Centers for Disease Control (CDC)

Optimizing the use of antibiotics is critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance. Antibiotic stewardship programs can help clinicians improve clinical outcomes and minimize harms by improving antibiotic prescribing. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.

Core Elements of Human Antibiotic Stewardship Programs in Resource-Limited Settings

Centers for Disease Control (CDC)

This Core Elements is a guide for antibiotic stewardship program implementation in resource-limited settings that have fragile health systems and lack robust, regulatory frameworks. It builds off the Core Elements resources originally created for U.S. healthcare settings to outline structures and functions associated with effective programs. The guide contains practical, high-impact strategies based on both expert opinion as well as experiences in implementing antibiotic stewardship programs at the national and facility-levels to improve antibiotic use and fight antibiotic resistance. The guide provides a range of activities that a government or individual facility can implement based on the resources available.

Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals

Centers for Disease Control (CDC)

This document provides guidance on practical strategies to implement antibiotic stewardship programs in small and critical access hospitals. The suggestions provided are based on discussions with staff in small and critical access hospitals, several of which have implemented all of the CDC Core Elements.

STRIVE Infection Control Training

Centers for Disease Control (CDC)

The CDC/STRIVE curriculum was developed by national infection prevention experts led by the Health Research & Educational Trust (HRET) for CDC. Courses address both the technical and foundational elements of healthcare-associated infection (HAI) prevention. Courses can be taken in any order. Each course has 1 or more modules. Individual modules can be used for; new employee training, annual infection prevention training, and/or periodic training.

U.S. National Action Plan for Combating Antibiotic-Resistant Bacteria (National Action Plan)

Centers for Disease Control (CDC)

The National Action Plan directs federal agencies to accelerate response to antibiotic resistance by presenting coordinated, strategic actions to improve the health and well-being of all Americans across the One Health spectrum. It has pushed transformative improvements across the country that strengthen and expand the ability to respond to these threats. The National Action Plan supports five main goals: 1. Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections; 2. Strengthen National One Health Surveillance Efforts to Combat Resistance; 3. Advance Development and Use of Rapid and Innovative Diagnostic Tests for Identification and Characterization of Resistant Bacteria; 4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines; and 5. Improve International Collaboration and Capacities for Antibiotic-Resistance Prevention, Surveillance, Control and Antibiotic Research and Development.

2021 NHSN Training videos

Centers for Disease Control (CDC), National Healthcare Safety Network (NHSN)

NHSN subject matter experts have created training videos for 2021 NHSN updates. Recorded presentations cover the following topics:

  • LabID Analysis in Acute Care Hospitals – FAQs and Troubleshooting
  • MRSA Bacteremia and CDI LabID Event Reporting – Refresher
  • Clarifications to 2021 Bloodstream Infection Definitions
  • 2021 Secondary BSI and Chapter 17 Updates
  • Catheter-associated Urinary Tract Infection (CAUTI) – Update
  • Ventilator-associated Event (VAE) and Pediatric Ventilator-associated Event (PedVAE) Analysis
  • Surgical Site Infection (SSI) – Updates and Refresher
  • Optimizing the Group User Analysis Experience
  • NHSN Antimicrobial Resistance (AR) Option: Facility-Wide Antibiogram Report
  • Internal Data Validation
  • Healthcare Personnel Vaccination Module: Influenza Vaccination Summary Reporting for IRF Units in LTACHs and IPFs

Antibiotic Resistance & Patient Safety Portal

Centers for Disease Control (CDC)

Interactive web-based application that was created to innovatively display data collected through CDC’s National Healthcare Safety Network (NHSN), the Antibiotic Resistance Laboratory Network (AR Lab Network), and other sources.  It offers enhanced data visualizations on Antibiotic Resistance, Use, and Stewardship datasets as well as Healthcare-Associated Infection (HAI) data.

Assessment of the Appropriateness of Antimicrobial Use in US Hospitals

Journal of the American Medical Association (JAMA) & Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

Importance Hospital antimicrobial consumption data are widely available; however, large-scale assessments of the quality of antimicrobial use in US hospitals are limited.

Objective  To evaluate the appropriateness of antimicrobial use for hospitalized patients treated for community-acquired pneumonia (CAP) or urinary tract infection (UTI) present at admission or for patients who had received fluoroquinolone or intravenous vancomycin treatment.

Conclusions and Relevance The findings suggest that standardized assessments of hospital antimicrobial prescribing quality can be used to estimate the appropriateness of antimicrobial use in large groups of hospitals. These assessments, performed over time, may inform evaluations of the effects of antimicrobial stewardship initiatives nationally.

Implementation of Antibiotic Stewardship Activities in Critical Access Hospitals – YouTube Video

CDC and HRSA’s Federal Office of Rural Health Policy

During this webinar, leading experts will discuss the implementation of antibiotic stewardship activities to measure and improve how antibiotics are used. The discussion will emphasize the uptake of hospital core elements in the U.S., and address overcoming barriers and practical suggestions for enhancing antibiotic stewardship activities in critical access hospitals. This webinar will be co-hosted by CDC and HRSA’s Federal Office of Rural Health Policy.

National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination

Office of Disease Prevention and Health Promotion (ODPHP)

In recognition of health care-associated infections (HAIs) as an important public health and patient safety issue, the U.S. Department of Health and Human Services (HHS) convened the Federal Steering Committee for the Prevention of Health Care-Associated Infections (originally called the HHS Steering Committee, but was changed to reflect the addition of agencies outside of HHS). The Steering Committee’s charge is to coordinate and maximize the efficiency of prevention efforts across the federal government. Members of the Steering Committee include clinicians, scientists, and public health leaders representing:

National Action Plans

Agency for Healthcare Research and Quality (AHRQ)

National Action Plans are developed with expert input to provide a framework for collaboration among Government and non-Government entities toward large goals that have significant impact on the Nation’s health.

  • Road Map to Elimination (HAI Action Plan) provides a road map for preventing HAIs in acute care hospitals, ambulatory surgical centers, end-stage renal disease facilities, and long-term care facilities.
  • National Action Plan for Adverse Drug Events identifies the Federal Government’s highest priority strategies and opportunities for advancement and seeks to engage stakeholders in a coordinated, aligned, multisector, and health-literate effort to reduce the ADEs that are most common, clinically significant, preventable, and measurable.
  • National Action Plan on Combating Antibiotic Resistant Bacteria provides a roadmap to guide the Nation in rising to the challenge of antibiotic resistance. It outlines steps for implementing the National Strategy for Combating Antibiotic-Resistant Bacteria and addressing the policy recommendations of the President’s Council of Advisors on Science and Technology.