Medication Appropriate Index (MAI) is used to assess the quality of antibiotic prescribing. The aim of the study to determine the risk factors of obstructive airway disease and to assess the appropriateness of ongoing antibiotic therapy using medication appropriate index criteria. A 6 months study was carried out at Karuna Medical College Chittur. The patient details were collected in a specially designed data entry form and results were statistically analysed using chi square test. During the study period, a total of 202 patients were enrolled. Out of this, 150 (74%) were male patients and 52 (26%) were female patients and Distribution of risk factors, ex-smokers 34 (15%) were more prone to infective exacerbations, followed by smokers 34 (17%), alcoholics 33 (16%), allergies 12 (6%), ex-alcoholics 8 (4%) and patients with both smoking and alcoholism were 10 (5%). The most common problems were seen with indication (68%), duration of therapy (74%), and dose of antibiotic (81%), directions (68%), duplication (64%), effectiveness (75%) and expensiveness (68%). The level of significance was assessed and found to be significant. Males are more affected than females. The cigarette smoking influences the rate of influence of lung function by causing path physiologic changes in airways, including inflammation hyper responsiveness. Using medication appropriate index criteria when comparing inappropriate v/s marginal and inappropriate v/s appropriate both shows high level of significance which imply antibiotic therapy was inappropriate. It is found that inappropriate use of antibiotics will increase the burden of multi-drug resistance. Prescribing under generic name is considered economical and rational