Small and Critical Access Hospitals

Improving the use of antimicrobials is an important patient safety and public health issue as well as a national priority. A growing body of evidence demonstrates that hospital Antimicrobial Stewardship Programs can optimize the treatment of infections and reduce adverse events associated with antibiotic use, such as Clostridioides difficile infection.

In 2014, the Centers for Disease Control and Prevention (CDC) recommended that all acute care hospitals implement Antibiotic Stewardship Programs, publishing the Core Elements of Hospital Antibiotic Stewardship Programs. However, results from the National Healthcare Safety Network (NHSN) annual hospital survey indicate disparities in implementation of the core elements among hospital types; in 2015, more than 50% of hospitals with more than 50 beds reported meeting all seven core elements compared to 26% of hospitals with 25 or fewer beds.

In 2017, the CDC released the Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals. The document, developed by the CDC collaboration with The American Hospital Association, The Federal Office of Rural Health Policy, and The Pew Charitable Trusts provides guidance designed to address the unique challenges small and critical access hospitals face.