ABSTRACT Acute Respiratory Infection (ARI) is one of infectious diseases with high incidences, especially in developing countries such as Indonesia. The infection caused by bacteria that it needs antibiotic therapy. Accuracy in selecting and use of antibiotics is also important to achieved a rational treatment. The aim of this research to determine the usage patterns and the accuracy using antibiotics for the treatment of ARIs in children under five years in RSUD Kabupaten Temanggung period 2016. This research use non experimental descriptive method and the data was collected retrospectively from medical records. The samples of this research were 77 patient with ARIs in children under five years got an antibiotic for therapy. The method for sampling was using purposive sampling, the sampel is taken with theprovisions of researcher (based on the inclusion criteria). The results showed that the usage pattern of antibiotics in patient with ARIs in children under five years are 84,41% of cefotaxime, 11,69% of ceftriaxone, 2,60% of amoxicillin, and 1,30% of cefadroxil. In addition, the accuracy of antibiotics used based on the patient’s exact criteria (100%), indication’s exact (93,50%), exact drug (92,21%), exact dose (6,50%) and the interval time’s exact (81,82%).