Background: Antimicrobial medicine (AMM) utilization patterns and rational drug use are important topics in today’s world wrought with AMM resistance, irrational prescription of antibiotics, and lack of proper training such as stewardship programmes for medical graduates and general practitioners. Our objective was to perform an audit of the antimicrobial drug utilization pattern, evaluate the rationality of drug use, and perform a cost analysis of these drugs.Methods: An observational cross-sectional study design was implemented. The study location was a tertiary care teaching hospital in suburban central India. Patients were recruited from the general medicine and general surgery departments.Results: Out of 189 patients, the average age was 45.714 years and 67.725% were females. A total of 595 AMMs were prescribed to 189 patients with an average of 3.148±1.578 drugs per patient. 6.5% drugs prescribed were generic, 95% prescribed were included in the national essential medicine list, and 90% of patients’ prescriptions were rational. The total expenditure on AMMs was ₹726043.610, with a median expenditure of ₹987.320.Conclusions: Drug utilization patterns vary between medicine and surgery departments. They also vary between different institutions within the same country. Creating a structured standardized training program to uniformly train healthcare professionals in conservative antibiotic prescription practices is needed. This study hopefully paves the way for future studies to target critical areas in AMM prescription and to prospectively assess the impact of a structured antibiotic stewardship program on AMM utilization patterns.