Core Elements of Antibiotic Stewardship for Health Departments


Ensuring appropriate use of antibiotics is one of CDC’s core strategies to combat the urgent threat of antimicrobial resistance and to provide the best, safe care. Antibiotic stewardship can optimize the treatment of infections and ensure equitable access to high quality health care. State and local health department antibiotic stewardship programs (SLHD-ASP) play an important role in guiding antibiotic stewardship efforts in various healthcare settings and promoting appropriate antibiotic use for all patients in their communities.

The Centers for Disease Control and Prevention (CDC) released the Core Elements of Antibiotic Stewardship for healthcare settings outlining structural and procedural components that are associated with successful antibiotic stewardship programs. This document adapts the Core Elements framework to outline the structure of a SLHD-ASP and provides recommended stewardship implementation activities based on experiences of successful SLHD-ASPs (Figure 1). State and local health departments vary by their capacity, resources, and governance. [1] SLHD-ASPs need to select and adapt stewardship strategies to best meet local healthcare needs. Smaller local health departments, U.S. territories, and Affiliated Pacific Islands can select specific implementation strategies based on their priorities and available resources. [2]

SLHD-ASP’s unique positions allow them to guide and support stewardship activities and collaboratives with a variety of partners including integrated health systems, payers, professional organizations, academic partners, quality improvement organizations, licensing and regulatory agencies, and others. SLHD-ASPs can work together as part of regional and national collaboratives to engage with different healthcare settings including acute care (e.g., hospitals, critical access hospitals, long-term acute care hospitals), outpatient care (e.g., ambulatory care, urgent care, dialysis, dental), and long-term care settings (e.g., nursing homes, skilled-nursing, ventilator skilled-nursing and assisted living facilities). [3, 4]

Core-Elements of Antibiotic Stewardship for Health Oblong

Figure 1: The Core Elements of Antibiotic Stewardship for Health Departments