Inhaled antibiotics for hospital- acquired and ventilator- associated pneumonia

To the Editor—We would like to comment on the hospital-acquired (HAP) and ventilator-associated pneumonia (VAP) guidelines recently published in Clinical Infectious Diseases [1]. These guidelines recommend inhaled antibiotics for patients with VAP due to gram-negative bacilli susceptible only to aminoglycosides or polymyxins and for patients not responding to intravenous (IV) antibiotics. It also suggests adjunctive inhaled colistin for HAP or VAP due to Acinetobacter strains susceptible only to polymyxins. Several important considerations related to inhaled antibiotics were not addressed