Step 1. Vaccinate hospitalized children and staff
- Vaccinate according to AAP/ACIP/AAFP recommendations
- Review immunization records and catch-up with routine vaccinations
- Give influenza vaccine to at-risk infants and children
- Give influenza vaccine to all healthcare workers

Step 2. Get the devices out
- Insert catheters and devices only when essential
- Use proper insertion techniques and follow guidelines for catheter-care
- Remove catheters and other devices when no longer essential

Step 3. Use appropriate methods for diagnosis
- Order appropriate laboratory tests
- Obtain appropriate specimens

Step 4. Target the pathogen
- Target empiric antimicrobial therapy to likely pathogens
- Target definitive antimicrobial therapy to known pathogens

Step 5. Access the experts
- Consult infectious disease experts for complicated infections

Step 6. Practice antimicrobial control
- Optimize timing, regimen, dose, route, and duration of antimicrobial treatment and prophylaxis
- Follow policies and protocols in your institution

Step 7. Use local data
- Know your regional, institutional, and high-risk unit-specific antibiograms
- Know your formulary
- Know your patient population (birthweight, age, and setting)

Step 8. Treat infection, not contamination or colonization
- Use proper antisepsis for drawing blood cultures
- Avoid routine culturing of catheter tips
- Treat bacteremia, not catheter colonization or contamination

Step 9. Know when to say “no”
- Avoid routine use of vancomycin, extended-spectrum cephalosporins,* carbapenems, oral quinolones, and linezolid
- Follow antimicrobial prescribing guidelines from CDC, AAP, and other professional societies

Step 10. Stop treatment
- When infection is unlikely
- When culture results indicate no clinical need for antimicrobials
- When infection is cured

Step 11. Practice infection control
- Be familiar with recommended infection control precautions
- Stay home when you are sick
- Stay home when you are sick
- Restrict visitors with symptoms of respiratory or gastrointestinal tract infections from contact with your patients

Step 12. Practice hand hygiene
- Wash your hands or use an alcohol-based hand rub before and after patient contact
- Set an example