Hospital Antibiotic Stewardship

Hospital Implementation of All 7 Core Elements

97%

national implementation in 2024

States with Greatest Implementation of Hospital Antibiotic Stewardship

49 states

with more than 90% of hospitals meeting all 7 Core Elements in 2024

Implementation Change from Previous Survey Year

⬆ 1%

The total percentage of hospitals reporting uptake of all 7 Core Elements increased by 1% from 2023 to 2024.

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 antimicrobial 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 hospital staff, and 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.

Data Source: National Healthcare Safety Network (NHSN)
Resources: About the Data
Years Included: 2014 - 2024

Core Element Implementation in 2024

Hospital Leadership Commitment: 100%

Dedicating necessary human, financial and information technology resources.

Accountability: 99%

Appoint a leader or co-leaders, such as a physician and pharmacist, responsible for program management and outcomes.

Pharmacy Expertise: 99%

Appoint a pharmacist, ideally as the co-leader of the stewardship program, to help lead implementation efforts to improve antibiotic use.

Action: 100%

Implement interventions, such as prospective audit and feedback or preauthorization, to improve antibiotic use.

Tracking: 99%

Monitor antibiotic prescribing, impact of interventions, and other important outcomes, like C. difficile infections and resistance patterns.

Reporting: 100%

Regularly report information on antibiotic use and resistance to prescribers, pharmacists, nurses, and hospital leadership.

Education: 100%

Educate prescribers, pharmacists, nurses, and patients about adverse reactions from antibiotics, antimicrobial resistance, and optimal prescribing.

Geographic Location

Implementation of antibiotic stewardship varies by state, and can be affected by state, local, and territorial health department programs and facility infrastructure and resources.

Hospital Antibiotic Stewardship by State

Core Element

Year

This map shows the variation by state in the percentage of U.S. hospitals that report implementation of CDC's Core Elements of Hospital Antibiotic Stewardship Programs by year. Implementation of the Core Elements is visualized in this graphic by aggregating acute care hospital responses to the NHSN Annual Hospital Survey by state. Each hospital answers questions related to antibiotic stewardship and responses are later mapped to the seven Core Elements: leadership commitment, accountability, pharmacy expertise, action, tracking, reporting, and education. Click on a state to see more information on that state's Core Element uptake.

Hospitals Implementing All 7 Core Elements in 2024

Changes Over Time

Implementation of antibiotic stewardship programs has been changing over time, driven by healthcare organization resources and priorities, state involvement in antibiotic stewardship efforts, regional collaborations, and accreditation requirements.

Changes Over Time in Hospital Antibiotic Stewardship (AS)

State

Core Element

This graphic shows the change over time in hospital implementation of antibiotic stewardship programs in All States by Core Element.

Hospitals Implementing All 7 Core Elements in All States Over Time

Core Element Reporting

In 2014, CDC released the Core Elements of Hospital Antibiotic Stewardship Programs to outline structural and procedural components that are associated with successful stewardship programs.

Hospital Antibiotic Stewardship Implementation by Core Element

Year

State

This graphic shows the percent of acute care hospitals that report implementation of Core Elements of Hospital Antibiotic Stewardship Programs in 2024.

Visit the United States Profile to learn more about Antibiotic Stewardship reporting by geography.

Hospital Core Element Reporting in All States in 2024

Priority Core Elements Reporting

In 2024, CDC identified specific priorities for hospital Core Element implementation. The Priorities are derived from six of the seven Core Elements to help enhance the quality and impact of antibiotic stewardship programs.

Hospital Antibiotic Stewardship Implementation by Priority Element

State

Year

The graphic shows the percent of acute care hospitals that report implementation of Priority Elements of Hospital Antibiotic Stewardship Programs for the nation in 2024. Visit the Visit the United States Profile to learn more about Antibiotic Stewardship reporting by geography.

Priorities for Hospital Core Element Implementation.

Hospital Priority Element Reporting in All States in 2024

Footnotes

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.