Antibiotic therapy of childhood pneumonia must be based on various factors. Among them, clinical skills, diagnostic studies, knowledge of possible etiologic agents and their in-vitro susceptibility, and avoidance of antibiotic overuse are of greatest importance. The challenge of selective treatment is the reality in developed countries. The equation of pneumonia with antibiotic therapy can no longer be accepted as absolute. If antibiotic therapy is indicated, a new macrolide is usually the drug of choice.