Antimicrobial Justification form for Restricting Antibiotic Use in a Pediatric Intensive Care Unit

To study whether introduction of an antimicrobial justification form deters clinicians from prescribing restricted antimicrobials and results in de-escalation of these antimicrobials.

Clinicians were asked to fill a justification form if prescribing an antimicrobial from the pre-identified restricted group. Antimicrobial usage pattern over next year was compared with that in the one year preceding the introduction of justification form.

Significant overall decrease in antimicrobial usage (40.5% vs 34.6%) was noted in the post-intervention group along with a significant increase in the de-escalation of antibiotics.

Introduction of a justification form before prescribing antimicrobials or at the time of deferring de-escalation can be useful in restricting usage of antimicrobials.