Background and Objectives: The National Antimicrobial Prescribing Survey (NAPS) is a novel digital antimicrobial auditing program. The Hospital NAPS, released in 2013, is used to monitor antimicrobials prescribed within a facility and identify targets for quality improvement initiatives. Since 2016, the Hospital NAPS has also become a key component of the Antimicrobial Use and Resistance in Australia (AURA) Surveillance System, providing actionable data at a local and national level to address the challenges of antimicrobial resistance. Methods: The Hospital NAPS uses a standardised point prevalence Methodology and assessment matrix to facilitate data collection on the appropriateness of antimicrobial prescribing and allow benchmarking. Deidentified data is then made available for national reporting and to inform antimicrobial prescribing guidelines and public health policy. Establishment of governance processes under a quality management system framework and ongoing feasibility assessments, have driven improvements in the program’s generalisability and sustainability. Results: Since released, over seventy percent of Australian hospitals have contributed across major cities, regional and remote settings. It can now be regarded as a national antimicrobial usage surveillance system with 407 hospitals contributing in 2021. Key findings have informed updates to national prescribing guidelines including respiratory tract infections, surgical prophylaxis and medication safety. The ongoing success of the Hospital NAPS program has driven the development of additional modules, including Surgical, Aged Care, Quality Improvement and Antifungal NAPS. Conclusions: The adaptability of Hospital NAPS has enabled successful pilots in New Zealand, Canada, United Kingdom, Portugal, Malaysia, Vietnam, Bhutan, Nepal, Papua New Guinea, Timor-Leste and Fiji, highlighting its across transferability various geographical locations and settings. Acceptable governance structures, along with robust in-built analysis and reporting capabilities, has supported such sustainability and scalability, ensuring broader impact globally to help address antimicrobial resistance.