Antimicrobial Stewardship in California: What You Need to Know

January 19, 2018

In an effort to improve the use of antimicrobial medications, California was the first state to enact antimicrobial stewardship legislation in 2006. Since then, the state has mandated enhanced antimicrobial stewardship programs (ASPs) in hospitals and other medical facilities.

The goal of the California Antimicrobial Stewardship Program Initiative is to enhance patient outcomes, reduce resistance to antibiotics, and decrease unnecessary costs. It provides guidance and support for California healthcare facilities to implement their own antimicrobial stewardship programs (ASPs). These programs promote and measure appropriate antimicrobial use by optimizing selection, dosing, route and duration of therapy.

ASPs also improve patient outcomes while minimizing adverse events associated with the use of antibiotics, such as toxicity, infections, and the emergence of antimicrobial resistant organisms.

New Requirements

Antimicrobial stewardship laws apply to a wide range of physicians, pharmacists, microbiologists, information technology specialists, and any other hospital leadership and support staff, and comes with a whole set of requirements you need to be aware of:

  • It requires hospitals to develop a process for monitoring the judicious use of antibiotics, the results of which are monitored by quality improvement committee(s).
  • Hospitals are further required to adopt and implement an antimicrobial stewardship policy in accordance with guidelines established by federal government and professional organizations, and to establish a physician-supervised multidisciplinary antimicrobial stewardship committee with at least one physician or pharmacist who has undergone specific training related to stewardship.
  • Skilled nursing facilities are required to adopt and implement an antibiotic stewardship policy.


The California Department of Public Health’s (CDPH) Healthcare-Associated Infections (HAI) Program provides guidance and support for California healthcare facilities to implement antimicrobial stewardship programs.

HAI program resources for hospitals and skilled nursing facilities include:

  • CDPH Spotlight on ASPs Project, which offers California hospitals an opportunity to highlight and publicly share their progress with ASP implementation on the HAI Program website. Spotlighted hospitals provide the contact information of their ASP leaders to facilitate mentoring and regional collaboration with other facilities. To enroll as a Spotlight facility, complete the enrollment survey online.
  • CDPH Hospital ASP Toolkit, which provides practical examples of local program implementation.
  • CDPH Hospital ASP Collaborative – 2015 (PDF) in which 150 acute care hospitals were engaged in beginning or enhancing their ASPs. The collaborative was structured as a learning and action network conducted via monthly webinar sessions. Collaborative session presentations are archived for reference.
  • Antibiotic Stewardship in Nursing Homes Webinar Series -2016, a six-part webinar series developed in collaboration with the California Association of Health Facilities to provide practical guidance for California skilled nursing facilities in developing their antimicrobial stewardship policies.

For more information or to share resources, contact the HAI Program at

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