Introduction: Inappropriate and excessive usage of antibiotics has led to an ever-expanding drug resistance phenomenon, such that some bacterial diseases have recently become untreatable. Antibiotic stewardship (ABS) programs are important for rationalizing the administration of antibiotics in hospitals, and studies have proven their effects on reducing costs and microbial resistance.

Method: The present study was conducted in the form of a clinical trial in which the effect of ABS targeted against vancomycin and carbapenems usage was evaluated in terms of the length of hospital stay and mortality in the PICU of Dr. Sheikh Children’s Hospital, Mashhad, Iran. This strategy implemented was reviewing the physicians’ prescriptions and providing feedback.

Results: In the PICU of Dr. Sheikh Children’s Hospital, vancomycin and carbapenems were inappropriately prescribed by the attending physicians in 78 and 48 % of cases, respectively. The mean number of days of both vancomycin and carbapenems usage decreased significantly in the intervention group in which the ABS program was implemented. However, no significant differences were observed between the two groups in the mean length of hospitalization and mortality.

Conclusions: Overall, it was concluded that pediatricians at Dr. Sheikh Children’s Hospital highly accepted and strongly implemented the ABS program. Our findings demonstrated that the program yielded favorable results that were similar to those of advanced hospitals. ABS programs are thus recommended for implementation in other hospitals.