OBJECTIVE: to find out the extent of antimicrobial use in different indication in the paediatric in–patient department of a tertiary care hospital. METHOD: After ethical approval, a prospective, cross–sectional, descriptive epidemiological study was commence in October, 2012 – December, 2012 in the paediatric inpatient ward of Burdwan medical college and hospital. All inpatient case records were examined and there was no patient contact in any form. Patient particulars including provisional diagnosis, investigations done and drug data was recorded on a customized data collection sheet. Basic drug indicators were selected to analyze the prescribing patterns. RESULT: In the present study, average number of drugs prescribed was 3.21; 24.39% of the medicines were prescribed by generic names. A fair number of drugs (96.58%) were prescribed from the NLEM–2011. This showed that rational drug use in respect to these indicators. In present study 67.60% injection were used. More than 60% drugs were supplied from hospital. In current study, in 95% of prescription antimicrobial drugs were prescribed. On average 1.68 AMBs were prescribed per prescription per day, indicating irrationally high antimicrobial use. Most of the infective disease was treated according to standard treatment guidelines. AMBs were prescribed on clinical judgments in majority of the patients rather than taking the specimen for culture. CONCLUTION: The results of this study have provided strong evidence for the irrational high use of antibiotics and injection, which lead to increase treatment cost.