At a glance
- State and local health department antibiotic stewardship programs 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 Core Elements of Antibiotic Stewardship for Health Departments outline the structure of state and local health department stewardship programs, antibiotic stewardship implementation strategies, and resources.
Overview
The Core Elements of Antibiotic Stewardship for Health Departments adapts the Core Elements frameworks used in healthcare settings to outline the structure of public health antibiotic stewardship programs and provides recommended stewardship implementation activities based on experiences of successful programs.
Core Elements document
![[thumbnail] (hidden)](https://www.cdc.gov/antibiotic-use/media/images/Core-Elements-ASHD-thumb.jpg)
CDC's framework for health department antibiotic stewardship programs.
Implementation resources
Below are additional CDC and partner resources that can support Core Elements implementation in health departments.
Leadership commitment
Dedicate human and financial resources for state and local health department antibiotic stewardship programs.
Accountability
Designate a leader or co-leaders, such as a physician and pharmacist, responsible for health department antibiotic stewardship programs.
Stewardship expertise
Ensure that the antibiotic stewardship program leader or co-leaders have expertise and experience implementing stewardship activities.
- Antibiotic Stewardship Courses
- Online Primer on Healthcare Epidemiology, Infection Control & Antimicrobial Stewardship | The Society of Healthcare Epidemiology of America (SHEA)
- Antimicrobial Stewardship Training Programs | Making a Difference in Infectious Diseases (MAD-ID)
- Antimicrobial Stewardship Certificate Program | Society of Infectious Diseases Pharmacists (SIDP)
- Antimicrobial Stewardship Course | Coursera
Action
Guidance and Policies
Support the implementation of antibiotic stewardship activities by leveraging local partners or stewardship collaboratives.
Examples of stewardship collaboratives
- Rochester Patient Safety Collaborative, C. difficile Prevention Collaborative | University of Rochester
- Minnesota One Health Antibiotic Stewardship Collaborative | Minnesota Department of Health
- Center for Stewardship in Medicine | University of Washington
Tracking
Monitor stewardship activities and antibiotic use data to inform and assess stewardship action across the spectrum of health care.
National Healthcare Safety Network (NHSN) resources
- Data Use Agreement Frequently Asked Questions for Health Departments and Facilities
- Antimicrobial Use and Resistance (AUR) Training
Tracking data on stewardship activities and Core Elements uptake
- Infection Control Assessment and Response Tools
- Health Deficiencies | Centers for Medicare and Medicaid Services (CMS)
Tracking data on antibiotic use
- Guide to Using Outpatient Antibiotic Prescription Data for Peer Comparison Audit & Feedback
- Measurement and Evaluation Approaches to Improve Outpatient Antibiotic Prescribing in Health Systems
Reporting
Report data on stewardship activities and antibiotic use to health department leadership, local partners, stewardship collaboratives, healthcare professionals and the public.
Examples of state honor rolls
- Minnesota Antibiotic Stewardship Honor Roll | Minnesota Department of Health
- Antimicrobial Stewardship Program Honor Roll | California Department of Public Health
- Long-term Care Antibiotic Stewardship Honor Roll | Massachusetts Department of Public Health
Providing prescriber-level audit and feedback with peer comparison
- CHARM (Collaboration to Harmonize Antimicrobial Registry Measures) Project | Ferris State University
- OASIS (Outpatient Automated Stewardship Information System) | Denver Health and Hospital Authority
- Audit and feedback Health Department Letter
Examples of stewardship annual reports
- Antibiotic Use and Stewardship in Minnesota: 2024 Update on Progress and Opportunities | Minnesota Department of Health
- Antimicrobial Stewardship Annual Report 2024 | Washington State Department of Health
Education
Provide antibiotic stewardship education to healthcare professionals and the public to optimize antibiotic use.
For other settings
A framework for implementing antibiotic stewardship in hospital settings.
A framework for implementing antibiotic stewardship in nursing home settings.
A framework for implementing antibiotic stewardship in outpatient settings.
A framework for implementing antibiotic stewardship in resource-limited settings.
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