For Immediate Release: September 27, 2019

Society for Healthcare Epidemiology of America

Contact: Tamara Moore / / 202-868-4008

Infectious Diseases Experts Applaud Inclusion of Antibiotic Stewardship in CMS Condition of Participation

Update Moves Closer to Goal of 20% Reduction in Inappropriate Antibiotic Use

Arlington, Va. (September 27, 2019) — The Society for Healthcare Epidemiology of America applauds the inclusion of antibiotic stewardship (ASP) in the Centers for Medicare and Medicaid Services (CMS) final rule released Wednesday on Conditions of Participation for hospitals and Critical Access Hospitals. These changes bring these care requirements into alignment with best practices in infection prevention and control and will help improve the safety of healthcare delivery to patients in these settings.

The new rule requires that ASPs, in addition to infection prevention and control programs, be active and hospital-wide for the ‘surveillance, prevention, and control of healthcare-acquired infections and other infectious diseases and for the optimization of antibiotic use.’ The update by CMS moves U.S. hospitals closer to the goal of making patients safer by reducing inappropriate antibiotic use by 20 percent in inpatient settings by 2020 with the adoption of a final rule that requires acute care hospitals and critical access hospitals to implement antibiotic stewardship programs. Surveillance is a critical aspect of infection prevention and control and is essential to implementing CMS’ requirement that hospitals develop appropriate infection prevention and control interventions to address issues identified through its detection activities.

SHEA’s guidelines are among documents cited for use in implementation of the stewardship and prevention requirements. These and other tools and resources will be integral for hospitals as they implement ASP and modernize infection prevention and control programs to comply with this rule.

“These revisions will bring the Conditions of Participation into alignment with advances made in patient safety best practices, and respond to the call to action in the National Action Plan to Prevent Health Care-Associated Infections Road Map to Elimination,” said Hilary Babcock, MD, MPH, president of SHEA. “Most notably, we are pleased to see the addition of an antibiotic stewardship requirement as antibiotic resistance is one of the most urgent threats to global health we face today.”

Antibiotic resistance contributes to the rapid spread of multi-drug resistant organisms for which few treatments are available. ASPs optimize antibiotic use to achieve the best clinical outcomes while minimizing adverse events and limiting selective pressures that drive the emergence of resistance and may also reduce excessive costs attributable to suboptimal antibiotic use. Effective antibiotic stewardship programs cover not only the judicious use of antibiotic treatments but also ongoing education and training efforts to other stakeholders involved in care delivery.


The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing physicians and other healthcare professionals around the world with expertise and passion in healthcare epidemiology, infection prevention, and antimicrobial stewardship. SHEA's mission is to prevent and control healthcare-associated infections, improve the use of antibiotics in healthcare settings, and advance the field of healthcare epidemiology. SHEA improves patient care and healthcare personnel safety in all healthcare settings through the critical contributions of healthcare epidemiology and improved antibiotic use.  The society leads this specialty by promoting science and research, advocating for effective policies, providing high-quality education and training, and developing appropriate guidelines and guidance in practice. Visit SHEA online at, and @SHEA_Epi.