Antibiotic use in hospitals is driving antimicrobial resistance in hospitals. Inappropriate antibiotic use and poor infection and prevention control are fuelling the increased resistance. This chapter reviews infection control measures to reduce antibiotic-resistant bacteria and healthcare associated infections in hospitals, including interventions and surveillance, and their cost-effectiveness. Antibiotic stewardship objectives, interventions and their cost - effectiveness are discussed. Some examples of local good antibiotic stewardship practices in EU countries are given. Recommendations regarding antimicrobial resistance and healthcare associated infection surveillance focus on national programmes and intensified international collaboration. To increase the success of educational antibiotic stewardship interventions, education of all professionals should start at the undergraduate level; other stakeholders should be involved to promote responsible antibiotic use in hospitals. Finally, directions for future research include assessing different measures of patient safety and robust study designs for implementing antibiotic stewardship strategies and the appropriate health-economic methodological choice for economic evaluations.