We performed a point-prevalence study of antimicrobial prescriptions in 9 pediatric postacute and long-term care (pPALTC) settings. Antimicrobials were prescribed for 5%-7% of residents including infectious (41%), noninfectious (24%), prophylaxis (24%), and unknown (11%) indications. Macrolides were often prescribed for noninfectious indications. Developing treatment guidelines are antimicrobial stewardship opportunities for pPALTC.