For a study, it was determined that individual hospitals might lack expertise, information resources, and educational tools that were to support antimicrobial stewardship programs (ASP). Studies established a collaborative, consultative network focused on hospital ASP implementation. Studies conducted a retrospective, longitudinal analysis of antimicrobial use (AU) in 17 hospitals that participated for at least 36 months during 2013–2018. ASP practice was assessed using structured interviews. Segmented regression estimated change in facility-wide AU after a 1-year assessment, planning, and intervention initiation period. Year 1 AU trend (1–12 months) and AU trend following the first year (13–42 months) were compared using relative rates (RR). Examined information consisted of over 2.5 million DOT and almost 3 million patient days. Hospitals that participated increased ASP-focused activities with time. Network-wide overall AU trends were flat during the first 12 months after network entry but decreased thereafter (RR month 42 vs month 13, 0.95, 95% CI:.91–.99). Large variation was seen in hospital-specific AU. Fluoroquinolone use was stable during year 1 and then dropped significantly. Other agent groups demonstrated a nonsignificant downward trajectory after the first year. Network hospitals increased ASP activities and reported a decline in AU over a 42-month period. A collaborative network is a unique model in which hospitals can access ASP implementation expertise to support long-term program growth.