This section provides additional resources for individuals interested in antimicrobial stewardship programs, including Materials and Forms, US Academic Medical Centers Online Stewardship Resources, International Online Stewardship Resources, and Other Resources.

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Materials and Forms

Contributed by Allina Regional Hospital Cardinal Health Pharmacy Solutions, Columbia University Medical Center, Intermountain Healthcare, the Johns Hopkins Hospital, and other members of SHEA's Antimicrobial Stewardship Task Force

  • Tools for Daily Activities of Stewardship (also see IV to PO tools):
    • Peri-Operative Antibiotic Prophylaxis Blank Poster, PDF (39 KB)
    • Adult Inpatient Antibiotic Approval Form, PDF (51 KB)
    • Antibiotic Recommendation Form, PDF (20 KB)
    • Blank Order Set for Antifungal Therapy, PDF (27 KB)
    • Antibiotic Stewardship 360: Optimizing Outcomes For Common Infectious Syndromes, PDF
  • Policies, Procedures, and Guidelines:
    • State Strategies to Address Antimicrobial Resistance – Survey Results (ASTHO), PDF (538 KB)
    • Sample Daily Pharmacist Checklist, PDF (268 KB)
    • Drug Use Evaluation Form, PDF (99 KB)
    • IV to PO Guidelines, PDF (380 KB)
    • IV to PO Worksheet, PDF (24 KB)
    • Justification and Protocol for Extended-Infusion Piperacillin/Tazobactam in Adult Patients,  PDF (240 KB)
    • Antibiotic Streamlining – Sample Pharmacist’s Daily Routine, PDF (76 KB)
  • Business Case, Request for Proposal, and Job Description Examples:
    • Building a Business Case for ASP Presentation, PDF (982 KB)
    • Antimicrobial Stewardship Program Proposal Sample 1, PDF (112 KB)
    • Cost Analysis, PDF (14 KB)
    • Antimicrobial Stewardship Program Proposal Sample 2, PDF (36 KB)
    • RFP for ID Consultation and Post Prescription Antibiotic Rounding, Allina Regional Hospital, 2008, PDF (104 KB)
    • Greater New York Hospital Association Antimicrobial Stewardship Toolkit, HTML
    • Minnesota Guide to a Comprehensive Antimicrobial Stewardship Program, PDF (221 KB)

US Academic Medical Centers Online Stewardship Resources

Other Resources