Objective To monitor the clinical distribution of Gram-positive pathogen infection and drug-resistance situation in hospitalized children with lower respiratory tract, and guide rational application of antibiotics. Methods The isolated cultures results and drug sensitivity test result of 1 219 sputum specimens in hospitalized children with lower respiratory tract were studied. Results The 1 249 strains were isolated from 1 219 sputum specimen samples. Among which, Gram-positive pathogen was 318 strains, accounting for 25.46% (318/1 249). In 318 strains Gram-positive pathogens, staphylococcus aureus was 127 strains (39.94% ), streptococcus pneumoniae was 92 strains (28.93% ), staphylococcus epidermidis was 76 strains (23.90%), and enterococcus was 23 strains (7.23%). Then, different strains of pathogens showed totally disparate drug-resistance situations, especially towards penicillin, and the drug resistant rate was highest (89.62% , 285/318), while the drug resistant rates were also high among erythromycin, cefazolin, oxacillin, azithromycin and clindamycin: 66.67% (212/318), 52.52% (167/318), 49.06% (156/318), 49.06% (156/318) and 43.08% (137/318); meanwhile, the isolated Gram-positive pathogens showed no drug-resistance to vancomycin and linezolid. Conclusions Only using antibiotics rationally according to pathogen identification and drug sensitivity test result, can effectively control the pathogen infections.