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Antimicrobial Justification form for Restricting Antibiotic Use in a Pediatric Intensive Care Unit. 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. CONCLUSION: Introduction of a justification form before prescribing antimicrobials or at the time of deferring de-escalation can be useful in restricting usage of antimicrobials.