Introduction: This study evaluates the use of antibiotic prophylaxis for prevention and development of ventilator associated pneumonia (VAP) in pediatric patients with moderate to severe traumatic brain injury (TBI) in order to promote best practices and use the appropriate resources. Methods: A retrospective cohort study of all pediatric patients, between 1 and 18 years, who were admitted and had moderate or severe TBI diagnosis at the Pediatric Emergency Hospital, Lima-Peru. Results: One hundred and forty-five patients with diagnosis of traumatic brain injury (TBI), who received mechanical ventilation for at least 48 hours, were evaluated. We obtained an incidence density of 44.60/1000 ventilator days. No relationship was found between antibiotic prophylaxis and the development of VAP. Likewise, it was found that performing oral hygiene with chlorhexidine reduces the risk of developing...