Background: Antibiotics are one of the most widely used drugs in hospitals, but they are often misused. The proper antibiotic use improves medication and cases safety, lowers drug intake, and costs, and reduces the proliferation of resistant species. Aim: To improve pattern of antibiotic use to improve health care service and decrease morbidity and mortality. Methods: This cross-sectional study was carried out in the pediatric department, faculty of medicine, Zagazig university on 1000 children. All patients were subjected to full medical history with stress on age, sex, diagnosis, past history and antibiotic regimen (begin, course, end). The investigation carried out to the patient were recorded. Thorough clinical examination was done. Clinical outcomes after the use of the antibiotics were carefully evaluated and registered. Results: 97.29% of the prescribed antibiotics were of the appropriate dose and 94.22% were of appropriate interval. 68.67% of the prescribed antibiotics fulfil the guidelines while 31.32% not fulfil the guidelines. The most frequently prescribed antibiotics are Ampicillin/Sulbactam and 3rd generation cephalosporin while the least prescribed antibiotics are Amoxicillin/Clavulanic and cotrimoxazole. Conclusion: Antibiotic misuse and overuse are common, contributing to the rise of bacterial resistance. As a result, it is critical to encourage the careful use of antibiotics in order to reduce the growth of resistance.