Objective To investigate the clinical effect,safety,and value of bronchofibroscopeguided bronchoalveolar lavage and topical antibiotics in the treatment of pediatric patients with severe pneumonia.Methods A total of 60 patients with severe pneumonia was randomly divided into two groups with 30 cases in each group.Patients in the control group were treated with conventional anti-infection therapy,while patients in the treatment group were treated with bronchofibroscope-guided bronchoalveolar lavage and topical antibiotics on the basis of conventional therapy.The sputum positive rate,clinical effect,hospital stays,treatment costs,and adverse reactions were compared to analyze its value.Results The total effective rate of treatment group was 93.3％,which was significantly higher than that (60.0％) in the control group (P ＜0.01).The sputum positive rate of treatment group was 80.0％,which was significantly higher than that (43.3％) in the control group (P ＜0.01).The hospital stays and the treatment costs of the treatment group were both significantly less than those in control group (P ＜0.01 orP ＜0.05).No serious complications were found in patients of the treatment group.Conclusions Bronchofibroscope-guided bronchoalveolar lavage and topical antibiotics in the treatment of pediatric patients with severe pneumonia show exactly clinical effects and significant improvement in dyspnea,which shortens the hospital stays,reduces the treatment costs,and has no seriously adverse reactions.Therefore,it is worthy of clinical promotion and application.