Antibiotic stewardship, or improving how antibiotics are prescribed and used, is critical for optimizing the treatment of patients who have infections, protecting patients from harm, and combating antibiotic resistance. In 2019, the Centers for Disease Control and Prevention (CDC) released “Antibiotic Use in the United States, 2018 Update: Progress and Opportunities”, which included information on how antibiotics were being used across all healthcare settings and highlighted data, resources, and examples of the advancement of stewardship activities. This update highlights new opportunities and further progress in antibiotic stewardship and the importance of integrating sepsis early detection and management since the release of the last report in 2019. During the intervening months, the COVID-19 pandemic has changed healthcare delivery in ways that have had an impact on antibiotic prescribing and presented new challenges that will be important to address for continued progress. Continuing to leverage data for action to inform stewardship activities and collaborate with partners is a priority for CDC to preserve existing gains and continue to make progress to improve antibiotic use.

This report contains:

• Data describing U.S. outpatient antibiotic prescribing rates and implementation of hospital antibiotic stewardship programs by state, including considerations for antibiotic stewardship during the COVID-19 pandemic.
• NHSN Antimicrobial Use Option updates and success stories.
• Recently published literature highlighting progress made and opportunities for improvement in improving antibiotic stewardship in outpatient and emergency department settings.
• New and updated resources for health departments, facilities, and healthcare professionals to implement antibiotic stewardship.
• Examples of key partner contributions to improve antibiotic prescribing practices across the United States and internationally.

CDC will continue to lead U.S. efforts to improve antibiotic use in humans, as outlined in the new National Action Plan for Combatting Antibiotic-Resistant Bacteria, 2020-2025. CDC’s work includes improving antibiotic use in inpatient and outpatient settings, promoting antibiotic use best practices, strengthening antibiotic use surveillance, integrating diagnostic stewardship and sepsis early recognition, and collaborating with partners to develop new antibiotic use guidelines.

Antibiotic Resistance and Patient Safety Portal

The Antibiotic Resistance and Patient Safety Portal is a resource to explore and visualize data on outpatient antibiotic prescribing, hospital antibiotic stewardship implementation, antibiotic resistance, and health-care-associated infections.