Objective：To investigate the distribution and antibiotic resistance of the pathogens in lower airways in intensive care units（ICU）. Methods：A total of 399 sputum strains isolated from ICU inpatients with lower airways infections during 2004 were analyzed by the software WHONET 5.3 for the drug susceptibility of pathogens. The results were compared with those from general ward inpatients. Results：The distribution of pathogen in ICU was significantly different from that in general ward. The rate of antibiotic resistance was significantly higher in ICU than that in general ward. Bacteria producing extended-spectrum beta-lactamase（ESBLs） were detected with a rate of 27.4%. Methicillin-resistant Staphylococcus（MRS） accounted for 78.6% of all Staphylococcus， resisting significantly to Macrolides， Cephalosporins and Fluoroquinolones. Conclusion：At present， opportunistic pathogens and multidrug resistant pathogens play a more and more important role in lower airways infection. Piperacillin／ tazobactam is suggested for the Pseudomonas aeruginosa from the inpatients in ICU. Carbopenems and Piperacillin／tazobactam for ESBLs-producing pathogens and Vancomycin for MRS.