In the era of drug resistance, the comprehensive management of bacterial pneumonia faces severe challenges. Effective prevention and control are crucial to improve the prognosis of patients and control the antimicrobial resistance ( AMR). Bacterial pneumonia pathogens include many common multidrug-resistant bacteria. Their resistance mechanisms are complex, and often lead to treatment failure and increased mortality. The diagnosis of bacterial pneumonia requires a combination of clinical manifestations, inflammatory markers, imaging, and pathogen detection to achieve early and accurate identification. In terms of treatment, emphasis is first placed on the rational selection of empirical treatment plans in the early stages of the disease. Secondly, it timely adjusts to targeted treatment after the etiological results are clear. Prevention strategies include multidimensional measures such as infection control, antimicrobial stewardship (AMS) and vaccination. This article systematically explains the etiological characteristics, diagnostic strategies, treatment principles, and preventive measures of drug-resistant bacterial pneumonia. It arms to provide systematic reference for clinical practice. The multidisciplinary collaboration and " One Health " strategy will comprehensively improve the diagnosis, treatment, prevention, and control levels of drug-resistant pneumonia.