OBJECTIVES: Antibiotics use is a global concern and an economic burden for the patients in the developing country like India. The prime objective of the current study is to understand the prescribing pattern and cost analysis of antibiotics used in infectious diseases. METHODS: An observational prospective pilot study was executed in the in-patient and out-patient settings of a general medicine ward in a tertiary care hospital. The data was collected in predesigned forms which contained demographics, complaints, medication profile of the cohort. The collected data was analysed on individual merits in order to comment on the appropriate usage of antibiotics. The prescriptions containing antibiotic in patients of all age groups were included; whereas the pregnant and lactating women were excluded. The appropriate use of antibiotics was assessed by considering the factors like wrong indication, wrong dose, extended and decreased duration of therapy.  RESULTS: In this study, 200 patients were enrolled, who were administered with various antibiotics like azithromycin (28.6%), ceftriaxone (18%), cefotaxime (24.6%), metronidazole (9.3%), ofloxacin (7.3%) and fixed dose of cefoperazone-salbactum (6%) and amoxicillin -clavulanic acid (6%).This study reveals that use of antibiotics in 42% cases were eligible to be cross intervened for better patient outcome. The inappropriate use of antibiotics was observed to be 30.15% in adults, 28.5% in both pediatrics and middle-aged group and 12.69% in geriatrics. The number of inappropriate prescriptions (42%) was relatively less when compared with appropriate prescriptions (58%), however the cost burden was 20.3% more in inappropriate prescriptions. CONCLUSIONS: Study manifests that antibiotics usage was inappropriate which increased economic burden on the cohort. The study, if projected with a multi-center approach will produce a fact sheet that would help decision makers to realize the significance of the issue to generate a dedicated policy towards use of antibiotics for improved patient care.