Objective To investigate the current management status of pathogen examination rate before antimicrobial treatment for hospitalized patients in tertiary hospitals, and provide reference to further improve the examination rate. Methods Questionnaire was designed using the "Questionnaire Star" platform. 38 tertiary comprehensive hospitals in Jiangsu Province were selected. The survey included the pathogen examination rate before antimicrobial treatment and management status of hospitalized patients, the pathogen examination rate before treatment with key antimicrobial combination, and the pathogen examination rate related to healthcare-associated infection(HAI) diagnosis. Results Among the 38 tertiary hospitals, 78.95% (n=30) monitored pathogen examination rate by the department of HAI management, 100% implemented standards equal to or higher than the standards for all categories (30%), restricted categories (50%), and special categories (80%) of antimicrobial agents, respectively. More than 50% hospitals included the detection of procalcitonin (PCT), 1, 3-β-D-glucan test (G-test), galactomannan test (GM test), and interleukin-6 (IL-6) in the pathogen examination, with PCT included in 73.68% hospitals. 15.79% (n=6) hospitals did not only capture therapeutic antimicrobial use in terms of medication purpose; 31.58% (n=12) hospitals included local antimicrobial use in terms of medication route; 52.63% (n=20) hospitals captured the time of medical prescription for the use of antimicrobial agents; 31.58% (n=12) hospitals captured the time of medical prescription for the pathogen examination. The average data of pathogen examination rate before antimicrobial treatment met the relevant requirements, while the average data of pathogen examination rate before treatment with key antimicrobial combination and that relevant to HAI diagnosis did not. Differences among hospitals were significant. Conclusion The management of pathogen examination rate before antimicrobial treatment in various hospitals implemented inconsistently in multiple aspects. Each medical institution should further promote the homogeneous monitoring on pathogen examination rate before antimicrobial treatment in strict accordance with the stan-dardized requirements.