Because the American Thoracic Society and Infectious Diseases Society of America in 2019 revised the Diagnosis and Treatment of Adults with Community-acquired Pneumonia Guidelines and rejected the use of broad-spectrum antimicrobial agents as a first choice, we investigated the association between the current status, i.e., the initial choice for nursing- and healthcare-associated pneumonia (NHCAP) of antimicrobial therapy and the in-hospital mortality rate. A total of 158 patients were classified according to the Japanese Respiratory Society Guidelines for the Management of Pneumonia in Adults, 2017 and examined retrospectively. Of patients who died of pneumonia that had led to hospitalization there was no significant difference between the number treated with or without broad-spectrum antimicrobial agents. It is not necessary to use broad-spectrum antimicrobial agents in all patients with NHCAP, even those with sepsis/severe disease or those at risk for bacterial resistance.