Antibiotic Stewardship in Small Hospitals: Barriers and Potential Solutions

Edward Stenehjem, David Y. Hyun, Ed Septimus, Kalvin C. Yu, Marc Meyer, Deepa Raj, Arjun Srinivasan

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Antibiotic stewardship programs (ASPs) improve antibiotic prescribing. Seventy-three percent of US hospitals have <200 beds. Small hospitals (<200 beds) have similar rates of antibiotic prescribing compared to large hospitals, but the majority of small hospitals lack ASPs that satisfy the Centers for Disease Control and Prevention's core elements. All hospitals, regardless of size, are now required to have ASPs by The Joint Commission, and the Centers for Medicare and Medicaid Services has proposed a similar requirement. Very few studies have described the successful implementation of ASPs in small hospitals. We describe barriers commonly encountered in small hospitals when constructing an antibiotic stewardship team, obtaining appropriate metrics of antibiotic prescribing, implementing antibiotic stewardship interventions, obtaining financial resources, and utilizing the microbiology laboratory. We propose potential solutions that tailor stewardship activities to the needs of the facility and the resources typically available.

Original languageEnglish (US)
Pages (from-to)691-696
Number of pages6
JournalClinical Infectious Diseases
Issue number4
StatePublished - Aug 15 2017


  • antibiotic prescribing appropriateness
  • antibiotic stewardship
  • small community hospital

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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