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The AAAHC Institute for Quality Improvement has released a new toolkit to enhance antibiotic stewardship programs. The resource is designed to help develop and evaluate antibiotic stewardship policies and practices to ensure top-performing interventions are being deployed for optimal patient outcomes.

According to Naomi Kuznets, PhD., vice president and senior director of the AAAHC Institute, antibiotic resistance is a critical threat to public health, and the development of “superbugs” that are immune to even last resort antibiotics is becoming increasingly problematic.

“The most important factor contributing to antibiotic resistance is antibiotic misuse, and antibiotic stewardship programs seek to optimize use,” said Kuznets. “Stewardship activities are intended to improve clinical outcomes associated with antimicrobial use, minimize adverse events, reduce costs of infections and limit antimicrobial resistance.”

Evaluate Stewardship Activities

The AAAHC Institute designed the Antibiotic Stewardship Toolkit to aid ambulatory health facilities in promoting appropriate antibiotic selection while reducing overuse through an overview of illnesses for which inappropriate antibiotic prescriptions are written.

The Centers for Disease Control and Prevention (CDC) define antibiotic stewardship activities as efforts to improve and measure antibiotic prescribing by minimizing inappropriate antibiotic prescribing and overuse, as well as ensuring the right drug, dose and duration are selected when antibiotics are needed.

Providers in ambulatory health care settings use the AAAHC Institute Antibiotic Stewardship Toolkit checklist as both a baseline assessment of policies and practices, and a resource for reviewing and expanding activities on a regular basis.

The core elements of the checklist focus on four areas of stewardship activity:

  • Commitment: Demonstration of dedication to and accountability for optimizing antibiotic stewardship activities
  • Action: Implementation of policies and practices to improve antibiotic prescribing
  • Tracking and Reporting: Documentation of facility monitoring practices for antibiotic prescribing
  • Education and Expertise: Supplementation of resources for clinicians and patients on evidence-based antibiotic prescribing


The toolkit focuses on establishing a foundation of stewardship activities and improving them regularly to ensure they are meeting the needs of the patients served.

Importance of Ambulatory Care

The CDC estimate drug-resistant bacteria cause at least 2 million illnesses and 23,000 deaths annually in the United States.

“While historically, the vast majority of drug-resistant bacteria have been identified in hospitals, the vast majority of antimicrobials are administered to patients in the United States in outpatient settings,” said Kuznets. “This makes the ambulatory setting a priority area to implement antibiotic stewardship programs.”

The AAAHC Institute created the toolkit specifically for outpatient antibiotic stewardship programs, helping ensure the interventions are scalable to meet the needs of a variety of providers and programs ranging in size and scope.

The Antibiotic Stewardship Toolkit is available for purchase at for $10. For more information on antibiotic stewardship or ASC accreditation, visit




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