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Abstract This study to determine efficacy of the addition of clarithromycin to ventilator associated pneumonia care bundle to help in prevention of VAP in a critical care unit with a high prevalence of multi-drug resistant organisms so we found that administration of clarithromycin for 3 days inhibits the productions of pro-inflammatory cytokines with concomitant reduction of development of VAP in mechanically ventilated patients but without affection the incidence of mortality |