CMS SOM App. A, Tag A-0764

as well as best practices, for improving antibiotic use; and

Interpretive Guidelines §482.42(b)(3)

Hospitals must implement and maintain an active and hospital-wide antibiotic stewardship

program consistent with nationally recognized standards for improving antibiotic use.

Optimizing the use of antibiotics is critical to effectively treat infections, protect patients from

harms caused by unnecessary antibiotic use, and combat antibiotic resistance.

For example, the Centers for Disease Control and Prevention (CDC) provides “Core Elements

of Antibiotic Stewardship” at https://www.cdc.gov/antibiotic-use/core-elements/index.html.

CDC’s Core Elements of Antibiotic Stewardship offer providers and facilities a set of key

principles to guide efforts to improve antibiotic use and, therefore, advance patient safety and

improve outcomes. There is no “one size fits all” approach to optimize antibiotic use for all

settings. The complexity of medical decision-making surrounding antibiotic use and the

variability in hospital size and types of care in U.S. healthcare settings require flexible programs

and activities.

Examples of other organizations that promulgate nationally recognized antibiotic stewardship

guidelines and/or recommendations include and are not limited to: the Society for Healthcare

Epidemiology of America (SHEA), and the Infectious Diseases Society of America (IDSA), the

American Society for Health System Pharmacists (ASHP) and the Society for Infectious Disease

Pharmacists (SIDP).

Survey Procedures §482.42(b)(3)

• Verify evidence that nationally recognized standards have been implemented for their

evidence-based hospital-wide antibiotic stewardship program.

• Verify that core elements of best practices have been included within the hospital-wide

antibiotic stewardship program that may include: hospital leadership commitment,

accountability, pharmacy expertise, tracking, reporting, education, and appropriate

interventions or actions being taken to improve antibiotic use to reduce adverse events,

prevent emergence of resistance, and ensure better outcomes for patients in this setting.