Transforming antimicrobial usage : unveiling the impact of prospective audit and feedback in curbing overuse through a quasi experimental prospective study.

<bold>Background:</bold> Prospective Audit and Feedback (PAF) strategy of Antimicrobial stewardship programme (ASP) helps in reducing antimicrobial overuse but still not widely practiced in many hospitals. <bold>Aims:</bold> To measure Effect and Feasibility of PAF in ASP at a Tertiary care center. <bold>Objectives:</bold> 1. To evaluate the effectiveness of PAF in decreasing antimicrobial usage. 2. To investigate the influence of PAF on adherence of the hospital antimicrobial policy 3. To examine the impact of PAF in improving patient outcome. 4. To Assess the role of PAF in decreasing unintended consequences of the antimicrobial <bold>Methodology</bold> : STUDY: Prospective quasi experimental SETTING: MICU INCLUSION CRITERIA: >18 years age and >48 hours on selected antibiotics. EXCLUSION CRITERIA: Pregnant females <bold>Method:</bold> 1. The Baseline phase (Phase1): September 2022 – December 2022 – data collection. 2. The PAF phase (phase 2): January 2023 – April 2023. Feedback regarding antibiotics given and data collection. <bold>Primary outcome:</bold> Days of therapy (DOT) per thousand patient days <bold>Secondary outcomes:</bold> 1. Acceptance rate 2. Length of stay in the ICU 3. 30 days mortality rate 4. Unintended consequences /adverse drug reactions <bold>Results:</bold> 1. carbapenem DOT decreased significantly from 217 to 162 per thousand pt days 2. compliance to the hospital antibiotic policy increased from 40% to 51.5% 3. PAF acceptance rate was 75% 4. 30 day mortality and length of stay remain uncompromised. <bold>Conclusions:</bold> PAF strategy of ASP is Successful in reducing antimicrobial overuse in MICU without compromising mortality and length of stay. it has good acceptance rate and improves compliance to existing hospital antibiotic policies.