Background: Community-Acquired Pneumonia severely impacts of health cost and has a high mortality rate in Indonesia. Inappropriate use of empiric antibiotics can lead to an increase in treatment cost. This study aimed to compare the effectiveness and cost of empiric antibiotics treatment for adult hospitalized community-acquired pneumonia. Materials and Methods: The retrospective cohort study was conducted using medication record and insurance claim data. Patient with diagnosed CAP hospitalized in the ward, use antibiotics at least three days were included. Differences in effectiveness were analyzed by the chi-squared test. The ratio of effectiveness and cost were calculated to determine cost-effectiveness. Results: A total of 66 patients were included in the analysis, with 30 patients using levofloxacin, 23 patients using ceftriaxone, and 13 patient using ceftriaxone+ azithromycin combination. Cost-effectiveness was analyzed by comparing the direct total medical cost to clinical effectiveness, which was indicated by the respective success rates in each treatment group. Levofloxacin (96.7%) had good effectiveness based on clinical response compared to ceftriaxone (78.3%) and ceftriaxone + azithromycin combination (69.2%) with a p-value of 0.027, where the antibiotic group that was more cost-effective was levofloxacin with ACER value Rp. 52,223.20% effectiveness. Conclusion: Based on clinical response, it can be concluded that levofloxacin is more cost-effective than ceftriaxone and combination of ceftriaxone-azithromycin for treating CAP.