In this era of increasing antimicrobial resistance, the research field is steadily exploring other therapies, for example prophylactic therapies such as antibody-based preventive measures. A potential advantage of monoclonal antibodies (mAbs) is that they will not encourage bacterial resistance to the same extent as antibiotics, and may even augment antibiotic effectiveness [
14]. This study was designed in part to provide crucial information on the incidence, patient-related and contextual factors of ICU pneumonia caused by
S. aureus and
P. aeruginosa, but also inform the design of future phase III trials, that will investigate mAbs effectiveness against
S. aureus and
P. aeruginosa. Two large COMBACTE phase II trials, SAATELLITE (A Human Monoclonal Antibody Against
Staphylococcus aureus Alpha Toxin in Mechanically Ventilated Adult Subjects) and EVADE (Effort to Prevent Nosocomial Pneumonia Caused by
Pseudomonas aeruginosa in Mechanically Ventilated Subjects) have already started [
8]. SAATELLITE investigates the effect of MEDI4893, a mAb targeting
S. aureus alpha toxin and EVADE studies MEDI3902, which is another mAb that simultaneously targets PcrV and Psl on the surface of the
P. aeruginosa bacterium, in subjects at risk for ICU pneumonia [
5,
6,
8]. These targeted therapies, if proven effective, may be used in the future for patients at highest risk. This study will help to identify the subset of patients that will likely benefit most.