Hospital-acquired pneumonia (HAP) is the most common hospital-acquired infection, representing ∼22% of all hospitalacquired infections. 1 Also, antibiotic resistance is a growing concern throughout healthcare. 2,3 Studies on de-escalation of antibiotic therapy in HAP have shown outcomes to be no worse for patients who had antibiotics de-escalated compared with those who did not. [4][5][6] Therefore, it is prudent to further characterize existing rates of antibiotic de-escalation among HAP patients. In this study, we sought to determine whether any systematic differences in de-escalation patterns exist between 4 pathogen groups (ie, Enterobacterales, Staphylococcus aureus, Pseudomonas aeruginosa, and bacteria-culture-negative status) in patients with HAP and ventilator-acquired pneumonia (VAP) pneumonia.