In the United States, ventilator-associated pneumonia (VAP) is the most commonly diagnosed hospital-acquired infection in intensive care units (ICUs), affecting upward of 20% of ventilated patients with varyingly estimated attributable mortality ranging from 10% to 55%.1 Acquisition of VAP is responsible for prolonged ICU and hospital length of stay (LOS), increased hospital costs, and increased utilization of antibiotics. In a post hoc retrospective-matched cohort analysis of microbiologically confirmed cases of VAP in the North American Silver-Coated Endotracheal Tube study, the authors calculate median total charges for patients with VAP were almost $200,000 compared to under$100,000 for patients without VAP. This was accounted for by the patients requiring intubation up to 5 days longer and as a consequence, significantly prolonging their ICU and hospital stays by 11 and 13 days, respectively.2 A subsequent large, retrospective study comparing 2144 patients who had VAP as determined by International Classification of Diseases, Ninth Revision code to a matched cohort of patients without VAP showed similar findings. The patients with VAP had longer mean durations of mechanical ventilation (21.8 vs 10.3 days), prolonged ICU and hospital LOS (20.5 vs 11.6 and 32.6 vs 19.5, respectively), and an increase in hospital costs of almost \$40,000.3 The high attributable mortality and costs associated with VAP have garnered much attention from national patient safety organizations as well as state and federal health agencies, mandating compliance with preventive measures and reporting metrics.