Introduction: International Network for Rational Use of Drugs (INRUD) and other international organizations like World Health Organization (WHO) have put themselves into task for evolving rational use of medicines. In present generation any drugs have come into market for better management of patients but, irrational use of these medicines is leading to adverse effects besides safety and efficacy. Many standard guidelines for use of medications have been implemented. But, in developing countries like India, there is no one single guideline that to be followed by all health care hospitals. Aims and Objectives: To evaluate the pattern of prescription of antimicrobial in a tertiary care hospital. To analyse the patient adherence to medication. Materials and Methods: Present study was designed with its appropriate protocol and informed concern form and submitted to the Institutional Ethics Committee (IEC) for approval. After getting approval, the study was carried from Feb 2018 to Aug 2018 in the orthopedics department of Katuri Hospitals, Guntur District, Andhra Pradesh, India. Results and Discussion: Records revealed that Ampicillin + cloxacilline was prescribed in 48 patients with a percentage of 28.40%, Cefuroxime + linezolid were prescribed in 24 patients, 54 (31.95%) were prescribed with Ceftriaxone+ sulbactam, Cefoperazone + sulbactam was prescribed in 16 (9.46%) of study population prescribed with fixed drug combination of antimicrobials, Ceftazidime + sulbactam was prescribed in 27 patients with 15.97 of overall combinational drug prescriptions. Conclusion: It was observed from the study that in overall study population of 500 patients about 33.8% with a number of 169 patients to be prescribed with fixed dose combinations of antimicrobials. Among various fixed dose combinations, Ceftriaxone + sulbactam is the most frequently prescribed combinational drug. This represents that there is no unnecessary prescription of combinational drug use in the study hospital