Antibiotic resistance is aggravated by multiple factors related to subjects, prescribers, manufacturing processes and environment. India has very little information on antibiotic resistance, patterns of prescription and consumption of antibiotics. The purpose of the study was to evaluate the antibiotics prescribing and sensitivity patterns of pathogens in pulmonary medicine unit of a tertiary care teaching hospital in South India. This prospective observational study was conducted in pulmonary medicine unit over a year. Of 725 subjects enrolled, 62.3% were males. 74.9% were prescribed with antibiotics, majority receiving oral antibiotics (44.9%). Average number of antibiotics per prescription was 1.82. Only 50% of prescribed antibiotics were from the World Health Organisation-Essential Drug List (WHOEDL). Ceftriaxone (19.2%) was the most frequently prescribed antibiotic and the combination of cephalosporins with βlactamase inhibitors was the most prescribed antibiotic class. DDD/100bed days was highest for Cefpodoxime-clavulanic acid (24.7). Bronchial Asthma (14.2%) was the most prevalent disorder. 62.6% of the total 364 cultured samples were gram positive cocci and gram negative bacilli. Streptococcus pneumonia (10.7%) and Pseudomonas aeruginosa (24.2%) were the most prevalent gram positive and gram negative organisms respectively, in the tested cultures. Strenotrophomonas maltophilia, MRSA (n=10) and Non- fermenting gram negative bacilli (n=4) were resistant to most of the widely prescribed broad spectrum antibiotics. Continuous surveillance of susceptibility testing is necessary for customization of empiric antibiotic therapy. Furthermore, reliable statistics on antibiotic resistance and policies should be made available.