Multiplex respiratory PCR and serum procalcitonin based diagnostic algorithm to reduce antibiotic usage in critically ill children admitted with pneumonia

Children admitted to PICU with a diagnosis of pneumonia or lower respiratory tract infection requiring oxygen or higher respiratory support and meet and the inclusion and exclusion criteria will be included after informed consent. Demographic data, clinical features and treatment received collected. Nasopharyngeal swab for respiratory using Multiplex PCR ans serum procalcitonin will be sent. Antibiotics will be stopped if no bacteria is detected and PCT is negative. Child will be monitored clinical and using Point of care ultrasound for any worsening symptoms. The control group will include historic cohort of previous year managed as per existing protocol. The change in antibiotics in historic cohort based on clinical decision, chest radiograph and inflammatory markers like CRP and total leukocyte counts will be compared with study group where antibiotic decisions are based on respiratory PCR and PCT reports.