India's antibiotic resistance problem is worsened by excessive antibiotic use and inadequate prescription practices. To address this issue, the current study was conducted in a rural secondary care referral hospital of southern India; which analyzed the pattern of antibiotic prescriptions using the WHO's AWaRe classification and specific indicators for antimicrobial usage in the hospital's pharmacy. The study included adult patients over 18 years old diagnosed with infections and prescribed at least one antibiotic, excluding incomplete prescriptions. In our study, ceftriaxone was the most commonly used (35.05%), followed by Amoxicillin/clavulanic-acid (14.8%) and azithromycin (13.83%). A total of 2618 drugs were prescribed with 23.76% of antibiotics in 384 prescriptions. On an average, there were 6.82 drugs and 1.62 antibiotics per encounter. Upon categorizing the antibiotics according to the WHO AWaRe classification, 62% of the total antibiotic prescriptions were in the Watch category, while one-third (36.5%) fell under the Access category, and 1.61% were categorized as not recommended, and the Access to Watch index is less than 1. In conclusion, our research highlights the pressing need to address gaps in responsible prescription practices; and this data can assist in shaping national formularies and antimicrobial stewardship strategies.