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Community-acquired pneumonia (CAP) is a common illness associated with high rates of morbidity and mortality worldwide. The β-lactam antibacterial agents have been the mainstay of therapy for CAP for over four decades and remain as first-line therapy. However, the impact of the substantial prevalence of resistance seen among the common respiratory pathogens, particularly penicillin and macrolide resistance among Streptococcus pneumoniae, is now an area for concern. CAP treatment guidelines often recommend the use of a macrolide or fluoroquinolone in conjunction with, or as an alternative to, β-lactam agents, but whether this is necessary is uncertain. This review outlines the historical use of β-lactam antibacterial agents in the treatment of CAP along with their ongoing therapeutic utility.