The CDC estimates that each year in the United States, more than 2 million patients are infected by an organism that cannot be treated by the recommended antibiotic, and more than 20,000 of these patients die. Not only does antibiotic resistance threaten the well-being of patients on a daily basis, the loss of effective antibiotics imperils our ability to deliver life-saving medical care like surgery and cancer chemotherapy. This document provides guidance on practical strategies to implement antibiotic stewardship programs in small and critical access hospitals, based on discussions with staff in these care settings.