Improve Antibiotic Use

The Issue

Each year in the United States, at least two million illnesses and 23,000 deaths can be attributed to antibiotic-resistant infections.

While antibiotic-resistant infections can happen anywhere, most deaths related to antibiotic resistance happen in health care settings such as hospitals and nursing homes.

CDC’s 6|18 Initiative In Action

Learn about interventions happening across the country. Learn more »


Plan an Evidence-Based Intervention

Following is the intervention to improve antibiotic use identified by the CDC as having a proven evidence base for improving health outcomes and controlling health care costs:

  • Require antibiotic stewardship programs in all hospitals and skilled nursing facilities, in alignment with CDC’s Core Elements of Hospital Antibiotic Stewardship Programs and The Core Elements of Antibiotic Stewardship for Nursing Homes.
  • Improve outpatient antibiotic prescribing by incentivizing providers to follow CDC’s Core Elements of Outpatient Antibiotic Stewardship.

Evidence Summary: Improve Antibiotic Use

Download the CDC’s evidence summary that outlines key cost and health information for payers and providers, as well as demonstrated outcomes for the above intervention.

Explore Implementation Resources

The following resources can help payers, state officials, and providers to implement high-opportunity interventions aimed at improving antibiotic use. Does your state/program have resources to share? Send an email to

See also CDC’s antibiotic prescribing and use web page.

Core Elements of Antibiotic Stewardship by Health Care Setting

  • The Core Elements of Outpatient Antibiotic Stewardship – Report provides a framework for antibiotic stewardship in outpatient clinicians and facilities that routinely provide antibiotic treatment. It includes a companion checklist. (CDC, 2015)
  • Core Elements of Hospital Antibiotic Stewardship Programs – Document summarizes elements of successful hospital antibiotic stewardship programs. It includes a checklist that can be used to ensure optimal antibiotic prescribing and limit overuse and misuse of antibiotics. (CDC, 2014)
  • Antibiotic Stewardship for Nursing Homes – Document adapts the CDC’s Core Elements of Hospital Antibiotic Stewardship Programs into practical opportunities to initiate or expand antibiotic stewardship activities in nursing homes. It includes a companion checklist. (CDC, 2015)
  • Antibiotic Stewardship at Small and Critical Access Hospitals Report – Document provides guidance on practical strategies to implement antibiotic stewardship programs in small and critical access hospitals, based on discussions with staff in these care settings. (CDC, 2017)
  • Antibiotic Stewardship in Resource-Limited Settings – Document provides a framework for implementing antibiotic stewardship programs in resource-limited health care settings, based on expert opinion and experiences in implementing these programs in the U.S. and globally. (CDC, 2018)

General Resources

  • Be Antibiotics Aware: Smart Use, Best Care – Website includes information and resources about a national effort to help fight antibiotic resistance and improve antibiotic prescribing and use. (CDC)
  • Patient Safety Atlas – Interactive datasets share state-by-state statistics on antibiotic resistance, healthcare-associated infections, outpatient antibiotic use, and inpatient antibiotic stewardship. (CDC)
  • The MITIGATE Antimicrobial Stewardship Toolkit – Guide provides practical opportunities for implementing CDC’s Core Elements of Outpatient Antibiotic Stewardship in adult and pediatric emergency department and urgent care settings. (L. May, K. Yadav, S.D. Gaona, R. Mistry, A. Stahmer, D. Meeker, J. Doctor, and R. Fleischman)
  • A Field Guide to Antibiotic Stewardship in Outpatient Settings – Guide provides a collection of implementation strategies, suggestions, and tools that can be used by outpatient healthcare providers and leaders to implement the Core Elements of Outpatient Antibiotic Stewardship. (Quality Improvement Organizations, July 2018)

Health Care Professional and Consumer Engagement

  • Public Health Grand Rounds – Be Antibiotics Aware: Smart Use, Best Care – Video features experts who discuss efforts to measure and improve antibiotic prescribing, lessons from improving antibiotic use in pediatrics, and what providers and health systems can do to improve use among adults. (CDC, 2018)
  • Antibiotic Prescribing and Use in Doctor’s Offices – Communication materials provide information on antibiotic resistance, and appropriate prescribing and use. Audiences include healthcare professionals, adults, parents of children, American Indians/Alaska Natives, and Spanish speakers. (CDC, 2018)
  • CDC Training on Antibiotic Stewardship – Online training with continuing education that is designed to inform healthcare professionals about proper antibiotic prescribing and encourage open discussion among physicians and patients. This course fulfills Improvement Activities (IA) Patient Safety and Practice Assessment (PSPA)_23 and PSPA_24 under the CMS Merit-Based Incentive Programs. (CDC)

State Examples

Sign Up for Email Updates

Sign up to receive updates about general and condition-specific resources.


You have Successfully Subscribed!