A Critical Need: More Data on Antimicrobial Stewardship Programs in Critical Access Hospitals

We read with great interest the recent update on National Healthcare Safety Network (NHSN) survey data from antimicrobial stewardship programs (ASPs) by O'Leary et al. 1 In particular, we are impressed with the substantial improvement reported by critical access hospitals (CAHs) meeting the seven Core Elements (19.6% in 2014 vs 88.9% in 2021). 1 CAHs face unique barriers to building and maintaining ASPs, given their inherent rurality, resource limitations, and lack of access to infectious diseases expertise and training. 2,3These factors, among others, may explain the 8% gap that exists in meeting the Core Elements between CAHs and other acute care hospitals, for which we request further data to understand this critical gap, given the sparse literature available on this topic. 1First, the authors report the number of facilities that responded to the survey, but do not report the overall survey response rate.