Background: CAP is prevalent in children. There is, therefore, a need for cost-effective measures to detect such conditions. antibiotic treatment. However, a gap usually emerges between clinical practice and pharmacoeconomics efficiency. Objectives: This research has strived to assess cost-effectiveness of different antibiotic treatment regimens for pediatric CAP patients and compare the findings with those of their actual usage behavior at Haji Makassar Hospital. Study Methods: This was an observational analytic study using a cross-section design. retrospectively. The medical history data from pediatric CAP patients from January to December 2024 was analyzed conducted using purposive sampling (n=60). Information regarding antibiotic combinations, direct medical costs, as well as efficacy was collected. Cost-effectiveness was evaluated using Average Cost Effectiveness Ratio (ACER) and Incremental Cost-Effectiveness Ratio (ICER). Results: Cefotaxime and Gentamicin combination was found to the most cost-effective regimen (ACER: IDR 1,276,889.86). Whereas, the triple regimen of ampicillin + Gentamicin had the lowest efficiency (ACER: IDR 2,264,672.61). But, the results of practice which showed that ampicillin + gentamicin was the most commonly used regimen (41 patients), although it was not the costeffective option choice. There was a marked difference found to exist between the pharmacoeconomic-optimal regimen and real-world clinical application. Conclusion: There appears to be a considerable disparity between pharmacoeconomic evidence and clinical practice in the management of pediatric CAP at Haji Makassar Hospital. The improvement of antibiotic policies through encouraging a switch to the cost-saving combination therapy cefotaxime and gentamicin is recommended for optimize resource utilization without adversely affecting outcomes.