Introduction: Antimicrobial stewardship is the use of the right antimicrobial for the right indication for the right duration and time in the right route. The evidence on the use of antimicrobials in Intensive Care Units, specifically in Kerala, is scanty, and hence the objective was to describe the pattern of use of antimicrobials in patients admitted to Intensive Care Units (ICUs) of the Government Medical College in Central Kerala. 

Method: This was a retrospective study conducted in the Department of Pharmacology, GMC Kottayam, with Institutional Review Board (IRB) clearance. The data collected from Medicine, Surgery, and Trauma Intensive Care Units (MICU, SICU, and TICU) of this Government Medical College for a period of one month in 2023 were analyzed using Jamovi 2.3.28. 

Results: A total of 227 (81.65%) received antimicrobials amongst 278 patients admitted in the ICUs. Four hundred and seventy-four antimicrobials were prescribed to 227 patients. The most common antimicrobial prescribed across all the ICUs was Metronidazole (114,24.05), and the most common group was the β-lactams (243, 51.26%). The majority drugs were from the Watch Category 249(52.53%). The average antimicrobial use per encounter was 2.09. The DDD/100 bed days of the ICUs were estimated as Anti-infectives- J- 1677.2 and Alimentary A -8.5. 

Conclusion: The most common across all ICUs was Metronidazole (114, 24.05%), and the most common group was β-lactams (243, 51.26%). The most common route of administration was parenteral, and the use of Access Drugs was less as compared to Watch drugs.