Several new antibiotics with activity for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) have recently become clinically available. All are variations of existing compounds. Doripenem is probably equivalent to the already available meropenem and is slightly more active than imipenem. Its stability in solution allows use in prolonged infusions. Ceftaroline has been approved by the US Food and Drug Administration for the treatment of community-acquired pneumonia, and may be appropriate for HAP/VAP without multidrug-resistance risk factors. Unfortunately, although active against methicillin-resistant Staphylococcus aureus (MRSA) in vitro, no patients in the ceftaroline clinical trial had MRSA pneumonia so this advantage remains theoretical. Televancin appears to be roughly equivalent to vancomycin, with potentially greater efficacy in MRSA isolates with high mean inhibitory concentrations, but with an equal to greater risk of nephrotoxicity. Tigecycline should not be used as front-line therapy for HAP/VAP but as salvage therapy only in patients infected with extremely drug-resistant pathogens. Colistin finds its greatest use in this same niche, although aerosolised colistin demonstrates trends toward improved outcomes. New antibiotics are clearly needed for nosocomial pneumonia.