Acute lower respiratory tract infection (ALRTI) is a common infectious disease in children, and it is also one of the main causes of hospitalization and even death of children, which can cause huge health and economic burden to the family and society.Clinically, there lacks reliable diagnostic reference criteria to distinguish between viruses, bacteria, and atypical pathogens, and the unreasonable use of antibiotics is widespread.This article reviews the current situation of anti-infective drug treatment in children with ALRTI and the management strategy of antibiotics, so as to provide reference for promoting the thinking of antimicrobial management and for improving the level of antimicrobial management.