CDC Releases Core Elements of Antibiotic Stewardship for Nursing Homes

September 15, 2015
Perry Gwen Meyers,

Columbia, MD –  Today the Centers for Disease Control and Prevention (CDC) released the Core Elements of Antibiotic Stewardship for Nursing Homes, new recommendations aimed at improving prescribing practices and reduced consequences of antibiotic-resistant infections in nursing homes. The Core Elements for Nursing Homes expand upon CDC’s recommendation last year that all acute care hospitals implement an antibiotic stewardship program designed to optimize treatment of infections while reducing adverse events associated with antibiotic use.

The Core Elements (summarized) are:

  1. Leadership commitment – support and commitment of appropriate antibiotic use 
  2. Accountability – identifying  physician, nursing, and pharmacy leads in facilities 
  3. Drug expertise – establishing access to antibiotic stewardship experts within facilities  
  4. Action – implementation of at least one policy or practice to improve antibiotic use 
  5. Tracking – monitor process measure of antibiotic use and outcome 
  6. Reporting – provide feedback to clinicians, nursing staff, and others
  7. Education – provide resources to staff, residents, and families 

CDC advises all nursing homes take steps to improve antibiotic prescribing practices and reduce their inappropriate use in order to protect residents from the consequences of antibiotic-resistant infections, such as C. difficile. The Core Elements provides examples of how antibiotic use can be monitored and improved by nursing home leadership and staff. A companion checklist is also available to help nursing homes assess policies and practices already in place and review progress in expanding stewardship activities on a regular basis.

AMDA – The Society for Post-Acute and Long-Term Care Medicine is proud to have had the opportunity to review the Core Elements and provide comments on them prior to their release. "AMDA very much values the opportunity to provide the ‘in-the trenches’ and the medical director perspective to the CDC Core Elements of Antibiotic Stewardship,” says AMDA President Naushira Pandya MD, CMD, FACP. “Working synergistically with the CDC and other national stakeholders will help to make viable antibiotic stewardship programs a reality." AMDA has been involved in the push to improve antibiotic stewardship for some time, and Dr. Pandya recently served on an expert panel at the White House Forum on Antibiotic Stewardship. 

This June AMDA, along with the University of Pittsburgh and University of Wisconsin, was awarded a 1.5 million dollar grant from U.S. Department of Health and Human Services Agency for Healthcare Research and Quality to investigate guidelines and tools to help post-acute and long-term care facilities better manage urinary tract infections (UTIs) reduce unnecessary use of antibiotics. AMDA member David A. Nace, MD, MPH, CMD, will serve as the principal investigator. AMDA will also utilize the Core Elements when revising the AMDA Clinical Practice Guideline on Common Infections to include more information on antibiotic stewardship. 


AMDA – The Society for Post-Acute and Long-Term Care Medicine is dedicated to excellence in patient care and provides education, advocacy, information and professional development to promote the delivery of quality post-acute and long-term care medicine.