The study objective is to assess and analyze the prescribing pattern and suspected ADRs related with antibiotics prescribed for respiratory tract infections to the paediatric inpatients of a tertiary care hospital. A prospective observational study was carried out for a period of 6 months. One hundred and twenty case records of the inpatients were enrolled. Total of 120 inpatient prescriptions were collected. Males were predominant over females. Majority of the patients were between the age group 1- 5 years. The most common diagnosis was pneumonia (51.67%) among 110 lower respiratory tract infectious patients. The total number of antibiotic prescribed in our study was 178. Penicillins (48.32%) were the top most used class of antibiotics in this study followed by Cephalosporins (27.53%). Among Penicillins, Amoxicillin + Clavulanic acid (38.76%) were found to be mostly used. Monotherapy of antibiotics was high (52.81%). 85.4% of the antibiotics were given parenterally. Antibiotics were prescribed to paediatric patients based on empirical therapy. Among 84 Fixed Dose Combinations prescribed Amoxicillin + Clavulanic acid (82.1%) was the most commonly prescribed. In conclusion, we provide evidence justifying the need to modify the current approach to the management of RTI in the paediatrics. Minimizing inappropriate antibiotic use is thus the best way to control resistance.