INTRODUCTION
pneumonia, pulmonary parenchyma infection, VAP, infection, XDR
INFECTION, PNEUMONIA
Multidrug‐resistant (MDR) or extensively drug‐resistant (XDR) Ventilator‐associated pneumonia (VAP), a type of hospital‐related pneumonia, is among the most commonly detected infection in ICUs. It is characterized as a pulmonary parenchyma infection in cases exposed to invasive mechanical ventilation for at least 48 h, with a high mortality and morbidity rate. VAP is reported to affect 5–40% of patients, with variations depending upon several factors.Timely treatment with appropriate antibiotics is crucial and improves survival in patients with VAP.Colistin is one of the choices for treating resistant Tobramycin is an aminoglycoside antibiotic that inhibits protein synthesis, and inhaled form has been used for VAP.Although various studies have reported the effect of inhaled use of the antibiotics colistin and tobramycin in the VAP treatment, the effect of using the inhaled fosfomycin/tobramycin combination in treating XDR 