Tehran University of Medical Sciences Journal of Pharmacoeconomics and Pharmaceutical Management 2383-4498 10 3 2024 09 30 1 7 Palevi Ruflianasari Master of Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada Tri Andayani Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada Dwi Endarti Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada 2024 06 12 2025 01 01 Background: Hospital Acquired Pneumonia (HAP) or nosocomial pneumonia is an infection caused mainly by gram-negative bacteria. Carbapenems and cephalosporins/cephalosporin siderophores are effective for infections caused by gram-negative bacteria. Objective: To compare the effectiveness of antibiotics from the Carbapenem group (meropenem) compared to the cephalosporin/cephalosporin siderophore group in HAP infections caused by gram-negative bacteria. Methods:  Sources of article searches used Cochrane and PubMed, which were then selected by the PICO method with a population of adult HAP patients, with comparator cephalosporins/cephalosporin siderophores that have clinical improvement outcomes with parameters of microbiological response and death, the flow chart PRISMA described it. Results: A total of 7 articles comprehensively discussed the effectiveness of cephalosporins/siderophore cephalosporins and meropenem against Klebsiella pneumonia, Pseudomonas aeruginosa, and Escherichia coli. The clinical recovery of patients after administering these two antibiotics showed high therapeutic effectiveness and could reduce mortality. Ceftazidime-avibactam, ceftolozane-tazobactam, and cefiderocol are new antibiotics that are effective for HAP. Meropenem at high doses can offset the efficacy of the three antibiotic combinations and minimize antibiotic resistance. Conclusion:  meropenem and cephalosporins/siderophore cephalosporins have similar effectiveness as therapy for gram-negative infections in HAP. https://jppm.tums.ac.ir/index.php/jppm/article/view/212 https://jppm.tums.ac.ir/index.php/jppm/article/download/212/153