Reply to Sopirala

To the Editor—We thank Dr Sopirala for her letter regarding the National Healthcare Safety Network (NHSN) ventilator-associated event (VAE) definitions [1]. We would like to address 2 concerns: (1) that VAE definitions misclassify present-on-admission conditions as nosocomial events, and (2) that de-escalation of antibiotics may result in classification of a VAE as an infection-related ventilator-associated complication (IVAC) rather than a ventilator-associated condition (VAC), and that this may lead some clinicians to continue broad-spectrum antibiotics inappropriately to avoid IVAC reporting.

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