Large Health Services Research Demonstration and Dissemination Projects for Combating Antibiotic-Resistant Bacteria (CARB)(R18)

The Large Health Services Research Demonstration and Dissemination Projects for Combating Antibiotic-Resistant Bacteria (CARB) is a funding opportunity managed by the Agency for Healthcare Research and Quality (AHRQ), part of the U.S. Department of Health and Human Services. This initiative stems from increasing national and global concern surrounding antibiotic resistance, which poses a major threat to public health. According to the CDC, over 2.8 million antibiotic-resistant infections occur in the U.S. annually, resulting in more than 35,000 deaths. In response, the White House released the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB NAP) in 2015, updated for 2020–2025, which serves as the guiding framework for this funding effort. This Funding Opportunity Announcement (FOA), PA-22-048, supports large-scale research projects under the R18 mechanism to demonstrate, disseminate, and evaluate strategies that promote appropriate antibiotic use, reduce transmission of antibiotic-resistant organisms, and prevent healthcare-associated infections (HAIs). Research funded under this opportunity must align with AHRQ’s mission to enhance the quality and delivery of healthcare services. Emphasis is placed on settings where antibiotic stewardship practices are less developed, such as long-term care and ambulatory environments. In doing so, the program seeks to expand successful interventions and evidence-based strategies across broader healthcare contexts. Eligible projects may address various facets of the antibiotic resistance challenge, including prescriber decision-making, integration of diagnostics, patient engagement, multidisciplinary stewardship models, and electronic health record (EHR)-based tools. Other areas of interest include the development and evaluation of implementation models that can sustain and scale up interventions across health systems, as well as regional approaches to curbing transmission across care settings. AHRQ encourages inclusion of equity-focused research and the analysis of outcomes across its defined priority populations. The program is open to a wide range of U.S.-based applicants, including public and private higher education institutions, nonprofits, local and state governments, tribal entities, and certain community-based organizations. For-profit and foreign institutions may not serve as lead applicants but may participate as collaborators or subcontractors. Applications must be submitted through one of the designated systems: NIH ASSIST, Grants.gov Workspace, or institutional system-to-system solutions. While letters of intent are not required, applicants must follow all guidelines outlined in the FOA and the SF424 (R&R) Application Guide. Notably, AHRQ employs different page limits and may deviate from standard NIH application formats. The maximum total funding available per project is $2.5 million over five years, with an annual cap of $500,000 in total costs. Cost sharing is not required but institutional support is encouraged. No clinical trial is required, though they are allowed. The deadline structure follows NIH’s standard dates, beginning with January 25, 2022, and the program expired early on March 20, 2026, per notice NOT-HS-26-016. Given the program’s expiration, applications may only be accepted under NIH’s late or continuous submission policies on a case-by-case basis. Contact for scientific inquiries includes Dr. David Calfee and Dr. Melissa Miller at AHRQ’s Center for Quality Improvement and Patient Safety. Submission-related questions should be directed to the eRA Service Desk or Grants.gov support. As this was a recurring opportunity with standard due dates, interested parties are encouraged to monitor future announcements from AHRQ for reissued or related funding opportunities.