Overview and Evidence to Support Appropriate Antibiotic Use
CDC works to improve antibiotic use in inpatient healthcare settings, such as acute-care facilities, through the implementation of antibiotic stewardship programs designed to ensure that hospitalized patients receive the right antibiotic, at the right dose, at the right time, and for the right duration.
Antimicrobial stewardship interventions have been proven to improve individual patient outcomes, reduce the overall burden of antibiotic resistance, and save healthcare dollars. If everyone — healthcare providers, hospital administrators, policy makers, and patients — works together to employ effective antibiotic stewardship programs, we can improve patient care, more effectively combat antibiotic resistance and ultimately save lives.
- Antibiotics are a shared resource – and becoming a scarce resource.
- Thirty to fifty percent of antibiotic use in hospitals is unnecessary or inappropriate.
- Antibiotic overuse contributes to the growing problems of Clostridium difficile infection and antibiotic resistance in healthcare facilities.
- Reducing unnecessary antibiotic use can decrease antibiotic resistance, Clostridium difficile infections, and healthcare costs, and improve patient outcomes.
- Interventions to improve antibiotic use can be implemented in any healthcare setting—from the smallest to the largest.
- Improving antibiotic use is a medication-safety and patient safety issue.
Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation
This educational initiative was designed to overcome and address the barriers to facilitate practical implementation of Antimicrobial Stewardship Programs in the community hospital setting led by the hospital pharmacist and infectious disease specialist in conjunction with other collaborating physician specialties. These sessions were recorded during a scientific roundtable meeting that was presented by the Centers for Disease Control and Prevention and titled “Antimicrobial Stewardship for the Community Hospital: Practical Tools & Techniques for Implementation,” which took place on August 24, 2010, in Atlanta, Georgia. Cooperating organizations for this initiative include the American Medical Association, the Association for Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the Society of Hospital Medicine, and the Society of Infectious Diseases Pharmacists.
Addressing the Rising Tide of Antimicrobial Resistance: Why Something Must Be Done
John G. Bartlett, MD (29:15)
The Proven Benefits of Antimicrobial Stewardship
Christopher A. Ohl, MD (41:12)
Assessing the Current Status of Antimicrobial Stewardship in Your Hospital
Edward J. Septimus, MD, FIDSA, FACP, FSHEA (38:44)
Management of Asymptomatic Bacteriuria in Hospitalized Patients: Room for Improvement
Sara E. Cosgrove, MD, MS, FSHEA (36:31)
The CMS Core (Performance) Measures for Community-Acquired Pneumonia (CAP): Relating to Antimicrobial Stewardship
Thomas M. File Jr, MD, MSc, MACP, FIDSA, FCCP (41:11)
Antimicrobial Prophylaxis in the Surgical Setting: Practical Application in Smaller Hospitals
Joseph S. Solomkin, MD, FACS, FIDSA (25:25)
Elizabeth Dodds Ashley, PharmD, MHS, BCPS (29:00)
Implementing an Antimicrobial Stewardship Program: The Pivotal Role of the Hospital Pharmacist
Robert C. Owens Jr, PharmD (36:39)
Appropriate Antibiotic Usage and Public Health: The Perspective From the CDC
Arjun Srinivasan, MD, FSHEA (19:11)
- Arjun Srinivasan, MD, FSHEA (Co-chair)
Associate Director for Healthcare Associated Infection Prevention Programs
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
- Christopher A. Ohl, MD
Associate Professor of Medicine
Section on Infectious Diseases
Wake Forest University School of Medicine
- Edward J. Septimus, MD, FIDSA, FACP, FSHEA
Clinical Professor of Internal Medicine
Texas A&M Health Science Center
Infection Prevention and Epidemiology
HCA Healthcare System
- Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS
Associate Director of Clinical Pharmacy Services
University of Rochester Medical Center
- John G. Bartlett, MD
Professor of Medicine and Epidemiology
Johns Hopkins University School of Medicine
- Robert C. Owens Jr., PharmD (Co-chair)
Co-Director, Antimicrobial Stewardship Program
Clinical Pharmacy Specialist, Infectious Diseases
Department of Pharmacy Services and Division of Infectious Diseases
Maine Medical Center
- Joseph S. Solomkin, MD, FACS, FIDSA
Professor Emeritus of Surgery
Department of Surgery
University of Cincinnati College of Medicine
- Sara E. Cosgrove, MD, MS, FSHEA
Associate Professor of Medicine
Division of Infectious Diseases
Director, Antibiotic Management Program
Associate Hospital Epidemiologist
Johns Hopkins Medical Institutions
- Thomas M. File Jr., MD, MSc, MACP, FIDSA, FCCP
Professor, Internal Medicine
Head of Infectious Disease Section
Northeastern Ohio Universities
Colleges of Medicine & Pharmacy
Chief, Infectious Disease Service
Summa Health System, Akron, OH
The faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
John G. Bartlett, MD: Advisory Board: Tibotec, Salient, Optimer; Honoraria: Abbott, Merck
Sara Cosgrove, MD, MS, FSHEA: Advisory Board: Forest, Rib-X; Consultant: Merck; Grant Recipient: Cubist, Astellas, Advan-Dx
Elizabeth S. Dodds Ashley, PharmD, MHS, BCPS: Consultant: Pfizer; Speakers Bureau: Merck
Thomas M. File Jr., MD, MSc, MACP, FIDSA, FCCP: Advisory Board: GlaxoSmithKline, Pfizer, Merck, Novartis, Cerexa, Forest, Protez, Nabriva, Tetraphase; Research Grant Recipient: Cerexa, Forest, Pfizer, Boehringer Ingelheim, Gilead, Tibotec
Christopher A. Ohl, MD: Advisory Board: Johnson & Johnson; Consultant: Johnson & Johnson; Speakers Bureau: Pfizer, Cubist
Robert C. Owens Jr., PharmD: Consultant: TheraDoc, Premiere
Edward J. Septimus, MD, FIDSA, FACP, FSHEA: Grant Recipient: AHRQ/CDC; Speakers Bureau: Cubicin, Merck, Sage
Joseph S. Solomkin, MD, FACS, FIDSA: Advisory Board: Johnson & Johnson, Merck, Optimer; Consultant: Cubist; Grant Recipient: Pfizer
CDR Arjun Srinivasan, MD, FSHEA: Nothing to Disclose
Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:
Otto Ratz, MD; Josh Paul; Bradley Pine; Blair St. Amand; Jay Katz; Kay Weigand; Paula Larson; Nothing to Disclose
There is a plethora of evidence to support the case for antibiotic stewardship interventions. Here are a few that highlight impact on costs, reduction of Clostridium difficile infections, use, and more.
Vital Signs Technical Appendix:
Estimating the Potential Reductions in Clostridium difficile Infection (CDI) among Patients when Antibiotic Use is Improved.
All of the following graphics are provided as a digital image (.jpg or .png formats) at a resolution that is acceptable for electronic and office print use.
The map shows the percentage of antibiotic stewardship programs in US hospitals by state. Antibiotic stewardship programs ensure patients get the right antibiotics at the right time for the right duration.
View outpatient antibiotic prescription data from QuintilesIMS (formerly IMS Health) Xponent data and U.S. Census files in an interactive database, CDC’s Antibiotic Resistance Patient Safety Atlas.
Percent of Hospitals with Antibiotic Stewardship Programs by State, 2018image icon (300 dpi resolution)
Percent of Hospitals with Antibiotic Stewardship Programs by State, 2017image icon (300 dpi resolution)
Percent of Hospitals with Antibiotic Stewardship Programs by State, 2016image icon (300 dpi resolution)
Audience: General public and healthcare professionals
Percent of Hospitals with Antibiotic Stewardship Programs by State, 2014image icon (300 dpi resolution)