adding pharmaceutical services to patient care and changing the professional activity of pharmacists from drug-focused to patient-oriented care,in the current study, clinical pharmacists will be assigned to monitor pharmacotherapy regimens, participate in patient care, and cooperate in educating the staff and evaluating care.

During the intervention period, the pharmacist attended daily unit rounds with ICU intensivist with a focus on optimization of antibiotic regimens. Pharmacist consultative services were also available by phone calls 24 hours x 7 days if needed. For every patient surgical prophylactic antibiotic initiated immediately before surgery and continued for 48 hours following surgery. Antibiotic therapy had given as either directed or empiric. Directed therapy was defined as treatment of a documented infection based on culture and sensitivity. Empiric therapy was defined as any antibiotic therapy administered when no documented infection was present, and the patient had clinically suspected infection following surgery. Empiric antibiotic administration was required in majority of our SICU patients. Antibiotics had given after exclusion of allergy by history and intradermal sensitivity test.

Inclusion Criteria:

• all admitted patients to the ICU between age 18-80 years old

Exclusion Criteria:

• Patient admitted for less than 24 hours (including deaths and transfers) will be excluded from the study.

Pediatric patients weighted less than kilograms.

All the information including the age, gender, comorbidity (presented as Charlson comorbidity index score ), surgical procedure done, patients' temperature, white blood cells count, type of infection (e.g., pneumonia, wound infection, Urinary tract infection,…..), prescribed antibiotics regimen either they will use empirical or based on cultures, results of culture sensitivity tests, length of stay, and mortality of patients