Community-acquired pneumonia (CAP) is one of the most common reasons for hospitalization in otherwise healthy Canadian children. The introduction of effective vaccinations, such as the pneumococcal conjugate vaccines, to the routine immunization schedule, has led to decreased rates of illness and, possibly, changes in the epidemiology of CAP in Canada. Unfortunately, in many children diagnosed with pneumonia, no causative agent can be isolated and up to date local data regarding the most common causes of pneumonia are difficult to obtain. The 2011 national guideline from the Canadian Paediatric Society (CPS)(1) and international guideline from the Infectious Diseases Society of America (2) recommend high-dose amoxicillin as the first-line treatment for otherwise healthy children with CAP who can be treated with oral antibiotics (1, 2). This recommendation was initiated before the widespread introduction of the 13-valent pneumococcal conjugate vaccine to immunization schedules, when penicillin-resistant serotype 19A disease was a rising concern. We sought to determine the appropriateness of this recommendation in our setting based on our current local Streptococcus pneumoniae susceptibility patterns.