Hospital Antibiotic Stewardship

Hospital Implementation of All 7 Core Stewardship Elements
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91%National implementation in 2020

U.S. Census Region with Greatest Implementation of Hospital Antibiotic Stewardship
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Northeast95% implementation in 2020

Implementation Change from Previous Survey Year
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Hospital Antibiotic Stewardship

Antibiotic stewardship has a number of proven benefits that include protecting patients from unintended consequences, improving treatment of infections, and helping combat antibiotic resistance. These data reflect programs in acute care hospital settings.

The implementation of antibiotic stewardship programs in acute care hospitals is assessed through the National Healthcare Safety Network's (NHSN) Patient Safety Component Annual Hospital Survey. Annual surveys are completed by staff in hospitals, and survey questions relating to antibiotic stewardship gauge a hospital’s uptake of CDC’s Core Elements for hospital antibiotic stewardship programs (ASPs), often referred to as the 7 Core Elements of Hospital ASPs.

Years Included

2014 - 2020

Core Element Implementation in 2020

more infoHospital Leadership Commitment: 99%

Dedicating necessary human, financial and information technology resources

more infoAccountability: 98%

Appointing a single leader responsible for program outcomes

more infoPharmacy Expertise: 98%

Appointing a single pharmacist leader responsible for working to improve antibiotic use

more infoAction: 99%

Implementing at least one recommended action, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e. “antibiotic time out” after 48 hours)

more infoTracking: 98%

Monitoring antibiotic prescribing and resistance patterns

more infoReporting: 96%

Regular reporting information on antibiotic use and resistance to doctors, nurses and relevant staff

more infoEducation: 94%

Educating clinicians about resistance and optimal prescribing


  • Although the vast majority of hospitals in the United States participate in NHSN, the antibiotic stewardship data summarized in this Portal may not be representative of all acute care hospitals in the United States. Also, because participation in NHSN varies by state and by year, caution should be used when making direct comparisons of uptake of core elements between states and across years.
  • Map legends are classified using the Jenks Natural Breaks method.