To analyze the distribution and drug resistance of pathogenic bacteria in children with community-acquired pneumonia (CAP) in a hospital in Guangzhou from 2017 to 2019, and to improve the clinical treatment of children with CAP.

The etiological data of 1686 children with CAP admitted to Guangdong Maternal and Child Health Hospital from January 2017 to December 2019 were retrospectively analyzed. According to age, gender and season, the above data were analyzed by SPSS 20 and WHONET software.

The incidence of CAP was mainly in spring (32.7%), and the incidence rate of children in 1 to 6 months was higher (72.4%). The main pathogens in different age groups were as follows: Escherichia coli (18.7%), Klebsiella pneumoniae (16.5%), and Staphylococcus aureus (15.6%) in children aged 1 to 6 months; children aged 7 to 12 months were susceptible to Streptococcus pneumoniae (20.7%) and Haemophilus influenzae (20.7%); and children aged 1 to 3 years were susceptible to Streptococcus pneumoniae (23.1%). In addition to vancomycin, all kinds of antibiotics were resistant to the 6 main pathogens to varying degrees. There was little overall change in bacterial resistance to most drugs during the three years, and only the differences in the resistance rates of individual drugs were statistically significant（P＜0.05）.

The distribution of CAP pathogens in children in Guangzhou was different between different ages and different quarters, and the drug resistance rate of individual drugs changed. Therefore, attention should be paid to the monitoring of etiological epidemiology and clinical characteristics of CAP in children.