At a glance
- Outpatient antibiotic stewardship programs promote appropriate antibiotic use to improve patient care and help combat antimicrobial resistance.
- The Core Elements of Outpatient Antibiotic Stewardship Programs provides a framework to improve antibiotic use and guide stewardship efforts for health systems, outpatient facilities, and prescribing clinicians.
- The guidance includes an assessment tool for evaluating stewardship efforts, a resource for measuring antibiotic use, and fact sheets that tailor stewardship strategies to specific outpatient settings.
Overview
Outpatient settings remain an important component of antibiotic stewardship. In 2026, CDC updated the 2016 Core Elements of Outpatient Antibiotic Stewardship based on published evidence and real-world implementation experience. The updated guidance outlines key structural and procedural components of effective outpatient stewardship programs and provides adaptable strategies to support stewardship efforts across outpatient settings.
The updated guidance places greater emphasis on the role health systems can play in improving antibiotic prescribing practices within their network, while continuing to highlight stewardship activities at the independent clinic and clinician level.
Effective antibiotic stewardship programs can protect patients and improve clinical outcomes.
Core Elements documents
![[thumbnail] (hidden)](/antibiotic-use/media/images/Core-Elements-Outpatient-Thumb.jpg)
![[thumbnail] (hidden)](/antibiotic-use/media/images/Core-Elements-Outpatient-Appendix-A-Thumb.jpg)
![[thumbnail] (hidden)](/antibiotic-use/media/images/Core-Elements-Outpatient-Appendix-B-Thumb.jpg)
Setting-specific strategies
The Site-specific fact sheets below provide considerations for adapting the Core Elements of Outpatient Stewardship Programs to address challenges and outline strategies unique to specific outpatient settings.
![[thumbnail] (hidden)](/antibiotic-use/media/images/Core-Elements-Outpatient-Dental-Thumb.jpg)
![[thumbnail] (hidden)](/antibiotic-use/media/images/Core-Elements-Outpatient-Hemodialysis-Thumb.jpg)
![[thumbnail] (hidden)](/antibiotic-use/media/images/Core-Elements-Outpatient-Telemedicine-Thumb.jpg)
Implementation resources
Below are CDC and external resources that can support Core Elements implementation in outpatient settings.
Leadership commitment
Dedicate necessary human, financial, and information technology resources to support stewardship programs.
Accountability
Designate a leader or co-leaders responsible for outpatient stewardship program development, management, and outcomes.
Expertise
Pair antibiotic stewardship expertise with outpatient setting-specific clinical expertise.
Action
Implement interventions, such as clinical decision support or audit and feedback, to improve antibiotic use.
- Improving Outpatient Antibiotic Prescribing: A Toolkit for Healthcare Payers
- MITIGATE Antimicrobial Stewardship Toolkit
- AHRQ Toolkit to Improve Antibiotic Use in Ambulatory Care
- Clinical Care of Outpatient Adult and Pediatric Populations
- A Commitment to Improving Antibiotic Use
- Antibiotic Stewardship for Oral Health | ADS - Association for Dental Safety
Tracking
Monitor antibiotic prescribing, the impact of stewardship interventions, and other important outcomes.
- Antimicrobial Resistance & Patient Safety Portal: Antibiotic Use & Stewardship Data
- Collaboration to Harmonize Antimicrobial Registry Measures (CHARM)
Reporting
Regularly report data on antibiotic prescribing and outcomes to healthcare professionals and leadership.
- Guide to Using Outpatient Antibiotic Prescription Data for Peer Comparison Audit & Feedback
- Example letter: Providing feedback to providers about number of antibiotics prescribed
Education
Educate healthcare professionals, patients, and caregivers on optimal antibiotic prescribing, adverse events, and antimicrobial resistance.