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A Resource Center for Implementing CDC’s 6|18 Initiative

Advancing Medicaid and public health adoption of evidence-based prevention strategies

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 state-based antibiotic use improvement program web page.

  • Preventing Healthcare-Associated Infections – Web page includes a wide variety of CDC-developed resources on preventing healthcare-associated infections — including prevention toolkits, checklists, and assessment tools to guide quality improvement efforts. (CDC)
  • Healthcare and Infection Control Gateway – Resource center offers tools for state health agencies on controlling and responding to infectious disease risks in healthcare settings, including a wide range of national and state-level resources. (Association of State and Territorial Health Officials)
  • Topic-Specific Infection Prevention – Online tool includes curated information on key infection prevention topics for health care professionals and consumers, including a topic-specific page on antimicrobial stewardship. (Association for Professionals in Infection Control and Epidemiology)
  • Infection Prevention and You – Website houses an extensive library of materials to promote infection prevention among consumers and health care professionals. (Association for Professionals in Infection Control and Epidemiology)
  • Alaska Antibiotic Stewardship Survey for Long-Term Care Facilities – Survey can be used to collect details on the status of implementing antibiotic stewardship programs in long-term care facilities. (State of Alaska, 2017)

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