Fifty-six patients with postpneumonic empyema were treated by sulbactam/ampicillin or cephalothin and netilmicin. Dose of sulbactam/ampicillin was 200 mg/kg per day and of cephalothin was 200 mg/kg per day, and of netilmicin was 5 mg/kg per day. Sulbactam/ampicillin alone was used in 27 patients. Twenty-nine patients were treated with cephalothin plus netilmicin. Days on intravenous antibiotics, days with chest tube, decortication rate, and duration of hospitalization were significantly shorter in sulbactam/ampicillin treatment group compared to cephalothin plus netilmicin group. This study shows that sulbactam/ampicillin is a safe and effective agent in the treatment of postpneumonic empyema in childhood.