ObjectiveTo analyze the choice of initial antibiotic treatment for health care-associated pneumonia (HCAP). MethodA retrospective study was conducted in patients with HCAP hospitalized in the Emergency Department of West China Hospital from January 1st to December 31st, 2014. A total of 156 HCAP patients were divided into anti-multidrug-resistant treatment group (group A, n=72) and quinolone monotherapy group (group B, n=84). The baseline characteristics, comorbidities, severity, pathogen distribution, antibiotics and clinical outcomes were compared between the two groups. ResultsIn group B, there were 46 males and 38 females with the age of (59.9±10.9) years, and the pneumonia severity index (PSI) score was 89.5±22.7; in group A, there were 44 males and 28 females with the age of (62.2±12.2) years, and the PSI score was 94.4±23.6. The differeces between the two groups were not significant (P>0.05). The duration of using antibiotics in group B was (14.5±3.7) days, which was longer than that in group A[(12.8±3.8) days, P=0.005]. The detection rate of multidrug-resistant bacteria, the proportion of changing antibiotics, the average length of hospitalization, the proportion of using mechanical ventilation, the proportion of patients transferred into Intensive Care Unit and 30 days mortality in group B was 17.9%, 34.5%, (16.9±3.6) days, 11.9%, 9.5%, and 4.8%, respectively; which were similar to those in group A[15.3%, 22.2%, (17.3±3.9) days, 16.8%, 12.5%, and 4.2%, respectively] (P>0.05). ConclusionsIt is unnecessary for all HCAP patients to receive anti-multidrug-resistant treatment. We should regard the risk factors and the popular local features of microbiology to determine the choice of antibiotic treatment.