Ventilator-associated pneumonia (VAP) continues to be a common and potentially serious complication of ventilator therapy, often addressed within an intensive care unit ( UTI). Ventilated and intubated patients present ICU physicians, nurses, and respiratory therapists with the unique challenge of integrating evidence-based practices related to the delivery of high-quality care that will reduce their occurrence and frequency. Mechanical intubation nullifies effective cough reflexes and hinders mucociliary clearing of secretions, which causes leakage and microaspiration of virulent bacteria into the lungs. VAP is the most frequent cause of nosocomial infections and occurs within 48 hours of intubation. VAP represents a serious healthcare burden due to increased morbidity, mortality, longer ventilator days and hospital stays, and increasing healthcare costs. VAPHunter, Annadurai, and Rothwell's Epidemiology defines ventilator-associated pneumonia as nosocomial pneumonia occurring in patients receiving more than 48 hours of mechanical ventilation via tracheal tube or tracheotomy. It is commonly classified as early-onset (occurring within 96 hours of starting mechanical ventilation) or late-onset (>96 hours after starting mechanical ventilation). A ventilator is a machine used to help a patient breathe by administering oxygen through an endotracheal tube, which is a tube inserted into a patient's mouth or nose, or through a tracheostomy, which is a surgical opening created through the windpipe in front of the neck. Infection can occur if bacteria or viruses enter the tube into the lungs or airways by manual manipulation of the ventilator tube. Ventilator-associated pneumonia accounts for 80% of hospital-acquired pneumonia, 8-28% of incubated pneumonia... center of paper... omomas aeroginosa. Meanwhile, a study led by Palmer found that inhaled antibiotics used in addition to systemic antibiotic therapy were shown to improve the clinical outcome of patients with MDR VAP (6). The aerosolized antibiotics used in this study that have been shown to be effective are: amikacin, colistin, ceftazidime, gentamicin, tobramycin, sisomycin, and yancomycin. However, increasing patterns of antibiotic resistance among intensive care unit pathogens, cultivated with empiric broad-spectrum antibiotic regimens, characterize variable concerns. Recent literature highlights that the use of antibiotics before the development of VAP is associated with an increased risk of potentially resistant grand-negative infections and methicillin-resistant Staphylococcus auereus (MRSA))