Abstract: 　Obiective　To study the clinical characteristics and therapeutic measures of the antibiotic associated diarrhea (AAD) in children with severe bacterial pneumonia. Methods The information of antibiotic use history in children with severe bacterial pneumonia from January 2013 to June 2013 was retrospectively analyzed. Results The incidence rate of AAD was 70.59% in children with severe bacterial pneumonia. According to the frequency, the third-generation cephalosporins, penicillin and carbapenems were the major causes of AAD. The percentage of the age ≤ 3 y, the duration of antibiotic usage> 7 d and the number of antibiotics ≥2 were significantly higher in AAD children than in non-AAD children (χ²=89.81~119.45, P<0.001). All the patients were improved after cessation or change of antibiotics. Conclusions The incidence of AAD in children with severe bacterial pneumonia is high, which is related to the age, the duration of antibiotic usage and the combination use of antibiotics.