2.1. Study design:
A retrospective observational study was conducted in the ICU of Elaraby hospital, Ashmoun, Menoufia, Egypt from April 2017 to January 2019. The inclusion criteria were Klebsiella isolates obtained from the clinical specimen of ICU patients aged more than 12 years during the study period. The data of the bacterial isolates were collected from the hospital laboratory records and the data of carbapenem consumption were obtained from the main pharmacy records. The ASP was started on 1 March 2018.