The article is focused on optimal strategy in the antibiotic treatment of severe community-acquired pneumonia in ICU. Basic principles for correct and effective choice of antibiotics, based on good knowledge of the most frequent etiological agents (especially pathogens typically associated with sever infection – Streptococcus pneumoniae and Legionella pneumophila) are desribed. The strategy of microbiological diagnostics, necessary for obtaining important data for pathogen-specific therapy of pneumonia is also described. Specific arguments are focused on problems of antibiotic resistance of respiratory pathogens in the national, European and world-wide context. There is especially critical importance of detailed and present-day knowledge of antibiotic resistance in the community at the national level, which has paramount impact for establishing optimal choice of antibiotics for initial therapy in the urgent situation in the critically ill patients. The most clinically effective pathogen-specific therapy, in the situation of known agent and its susceptibility to antibiotics is described in detail.

        Key words: choice of antibiotics – severe pneumonitis – antibiotic resistance – prevention