Prospective Validation of the Shamir Resistance Calculator: an Interventional Crossover Trial to Improve Empiric Prescription of Antimicrobials in Acute Care Hospitals.
Primary objective: \- Our aim is to validate the Shamir Resistance Calculator in a prospective crossover trial, in order to shorten the time to initiation of appropriate antimicrobials among hospitalized septic patients. Secondary objectives: \- To evaluate the impact of using the Shamir Resistance Calculator with regards to: * new acquisitions of multi-drug resistant organisms (MDRO) * the empiric usage of broad-spectrum agents (e.g., carbapenems, vancomycin) * acute Clostridiodes difficile infections * In-hospital mortality.
• Adult patients (age\>18 years)
• Patients who are hospitalized at Shamir MC or at Hadassah Medical Organization during the study period.
• o Patients admitted to the ER and later-on discharged home, or discharged from the ER to a different facility, will be excluded as it will not enable us to follow all the designated outcomes.
• Patients for which antibiotic treatment was initiated, empirically, due to acute sepsis.
‣ Patients for which antibiotics were initiated as part of a main-consolidative regimen, or as part of a pre-emptive regimen, will not be included in the study.
⁃ Sepsis will be defined in accordance to established criteria1.