Based on the 2019 NHSN Annual Hospital Survey, the CDC reported that 79.5% of critical access hospitals met all seven of the CDC’s Core Elements of Antimicrobial Stewardship Programs, compared to 92% of general acute care hospitals. Similarly, 82% of hospitals with 50 beds or fewer met all the core elements, as compared to 96% of those with more than 200 beds.In this episode of The ICHE Podcast, Dr. Dave Calfee speaks with three people who have been working to reduce these disparities in antimicrobial stewardship in small rural hospitals. They discuss this important issue and two papers that were published in the July 2026 issue of ICHE.Dr. Calfee is joined by Dr. Chelsea Chambers, an inpatient clinical pharmacy specialist at the James E. Van Zant VA Medical Center in Altoona, Pennsylvania; Dr. Julia Wasser, a clinical pharmacy specialist, inpatient program manager, and Pharmacy Residency Program director at the James E. Van Zant VA Medical Center; and Dr. Robin Jump, Associate Scientific Director of the Cleveland VA Medical Education and Research Foundation and a research physician at the VA Northeast Ohio Healthcare System.Links and Recommendations:- Recommendations made and accepted by a telehealth-enabled Antimicrobial Stewardship program implemented at rural veterans affairs medical centers: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/recommendations-made-and-accepted-by-a-telehealthenabled-antimicrobial-stewardship-program-implemented-at-rural-veterans-affairs-medical-centers/659F70C4B84BB0EC62C6A5876A7ECE19#article - Staffing and workflow of an interactive telehealth Antimicrobial Stewardship program with the Veterans Health Administration: https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/staffing-and-workflow-of-an-interactive-telehealth-antimicrobial-stewardship-program-with-the-veterans-health-administration/8764FF71B7A30A3702E0E01F10FFABDF- Dissemination and Implementation of a Telehealth-Enabled Program for Providing Infectious Disease Expertise in Rural Settings: https://pubmed.ncbi.nlm.nih.gov/40860515/