ISSUE: This is a 547-bed urban teaching hospital with 26,000 annual discharges. In the fall of 1999, the incidence of community-acquired methicillin-resistant <i>Staphylococcus aureus</i> (CA-MRSA) MRSA doubled; a year later, the incidence of nosocomial cases (N-MRSA) also doubled. By the end of 2002, the incidence of CA-MRSA had quadrupled and N-MRSA had tripled over the pre-2000 baseline. PROJECT: In August 2002, the infection control committee commissioned a task force (TF) to address this trend. Its primary goal was to implement the CDC Campaign to Prevent Antimicrobial Resistance. The first priority was to gain recognition and support from hospital leadership, then to aim advertising efforts at the entire hospital community. The TF was organized into four working groups (WGs). Each WG initiated at least one project. Project champions were chosen to lead each effort. The Prevent Infection (PI) WG sought to improve the number of inpatients immunized against influenza. In 2002-2003 only 95 inpatients were immunized. Diagnose and Treat (DT) chose to construct a standardized pathway for treatment of community-acquired pneumonia (CAP). No standard approach for management of CAP existed in 2002. Use Antibiotics Wisely (UAW) focused its efforts on establishing an antibiotic management team (AMT). In 2002, antibiotic oversight consisted of a specialized pharmacist and a restricted formulary requiring approval from an infectious disease (ID) fellow. Prevent Transmission (PT) implemented the CDC 2002 Guideline for Hand Hygiene in Health Care Settings. In 2002, poor hand hygiene practices were observed in many areas of the hospital. RESULTS: PI's campaign facilitated an increased influenza immunization of high-risk inpatients to >700 a year. DT involved multidisciplinary stakeholders to develop a CAP care path that was implemented in July 2004. Endpoints are tracked, and use of the pathway has increased. UAW established an AMT composed of an ID physician and a pharmacological doctor. Antimicrobial usage was reduced by 7%, and costs were reduced by 15% over the previous fiscal year. PT instituted an intense campaign to improve hand hygiene, which resulted in steady improvement. Since 2002, incidence of N-MRSA has decreased, while incidence of CA-MRSA has doubled. LESSONS LEARNED: Reduction of antibiotic-resistant organisms requires three components: support from leadership, effective project champions, and a marketing strategy to reach the entire workforce. The CDC's Campaign to Reduce Antimicrobial Resistance offers a vehicle and a strategy to reach these objectives.