The most effective strategy for combating antibiotic resistance is rational antibiotic prescribing. The percentage use of antibiotics has been used as a key indicator to determine whether the use of antibiotics is appropriate or not in pediatric patients. The aim of this study was to assess the use of antibiotics in paediatric inpatients treated at Felege- Hiwot comprehensive specialized hospital. To assess antimicrobial prescription pattern and associated factors among pediatric inpatients in Felege-Hiwot comprehensive specialized hospital, Northwest Ethiopia, 2021. Methods: Institutional based retrospective cross sectional study was done by reviewing 236 pediatric inpatients prescriptions prescribed from June 1 2021 up to August 30 2021. Data was entered and exported by using Epi Data manager version 4.4.1 and was analyzed by using SPSS version 25. Two hundred fifteen pediatrics patient prescriptions with antimicrobials were reviewed in this study giving a response rate of 92%. Out of 215 prescription papers 142 (66%) were prescribed for males. Sixteen patients got culture and sensitivity test for ampicillin, gentamycin and vancomycin. Diagnosis pattern were mostly empirical diagnosis (90%). From all antimicrobials prescribed, 145 (67.4%) were in the form of injectable followed by suspension/syrup 32(14.88). Sepsis was most common reason for hospitalization which accounts 52 (24.18%) followed by community acquired pneumonia 49(22.8%) and severe acute malnutrition 27(12.55%). By running multiple logistic regressions we found that residence, concurrent comorbid condition and change of the antibiotic dosage form after a certain days were significantly associated with antimicrobial prescription pattern. The practice of irrational antimicrobial prescribing pattern was high.. To increase the practice of rational antimicrobial Prescription Pattern, patients who come from rural remote area and patients who have comorbidities’ should get special emphasis.

Keywords: Antimicrobial, prescription pattern, culture and drug susceptibility,pediatric inpatients and Ethiopia.