title: Antimicrobial Justification form for Restricting Antibiotic Use in a Pediatric Intensive Care Unit.
abstract: OBJECTIVE
  To study whether introduction of an antimicrobial justification form deters clinicians from prescribing restricted antimicrobials and results in de-escalation of these antimicrobials.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Introduction of a justification form before prescribing antimicrobials or at the time of deferring de-escalation can be useful in restricting usage of antimicrobials.
authors.affiliation: Department of Pediatrics, Rainbow Childrens Hospital, Banjara Hills, Hyderabad, Andhra Pradesh, India. Correspondence to: Dr Preetham Kumar Poddutoor, Consultant Pediatrician, Rainbow Childrens Hospital, Vikrampuri Colony, Secunderabad 500 034, Hyderabad, Andhra Pradesh, India.
authors.forename: Harkirat Singh
authors.initials: HS
authors.lastname: Bhullar
authors.forename: Farhan Ar
authors.initials: FA
authors.lastname: Shaikh
authors.forename: R
authors.initials: R
authors.lastname: Deepak
authors.forename: Preetham Kumar
authors.initials: PK
authors.lastname: Poddutoor
authors.forename: Dinesh
authors.initials: D
authors.lastname: Chirla
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D055656:Prescriptions / Q000592:standards* / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011996:Records
chemical_list: D000890:Anti-Infective Agents