Comparison of antimicrobial stewardship programmes in acute-care hospitals in four European countries: A cross-sectional survey

•A formal antimicrobial stewardship programme was present mainly in the Netherlands (91%) and France (84%).•Presence of an antimicrobial stewardship (AMS) team ranged from 42% (France) to 94% (the Netherlands).•Lack of official salary support for AMS teams was an issue in all four countries, ranging from 68% (France) to 12% (Italy).•Countries varied substantially in the use of ‘prospective monitoring and advice’ as a strategy to improve AMS objectives.•Despite much recent effort to implement AMS at national and international levels, there is still room for improvement.