Aims &Objectives: To study the antibiotics dosage adjustment in renal impairement patients. To evaluate the rationalized use of antibiotics in a givenprescription based on renal dysfunction. Drug dosage adjustment in an individual renal impairement patients can maximize therapeutic afficacy and minimize adverse effects.This dosage adjustment also minimize the therapeutic costs, length of hospital stay and mortality as well as therapeutic effectiveness. Methodology: Prospective Observational Study was conducted on 150 Patients in a Teritiary Care Hospitals. Demographic data were extracted and creatinine clearance was calculated by using Cockcroft-Gault equation. Antibiotic dosages were compared with stanford guidelines dose recommendations to judge whether they were correctly adjusted or not. Results: Among 150 patients ,94 were male &56 were female. Out of all the patients,53 patients are done with dialysis .Totally 220 antibiotics were prescribed. Out of that 127 antibiotics require dosage adjustment,94 antibiotics were adjusted correctly and 33 were incorrectly prescribed. Piperacillin +tazobactam was the most frequently prescribed antibiotic requiring dosage adjustment (18.1%)followed by Levofloxacin(14%). Piperacillin + tazobactam was the majorly used antibiotic (63.6%) with inappropriate dose. In most of the cases inappropriate dosage adjustment (60%), guideline’s recommended dosing intervals were not followed. Of the unadjusted doses, 18 incorrect interval cases, 5 incorrect dose, and in 10 cases incorrect dose and interval were observed. Conclusion: Approximately 71.3% antibiotics were adjusted appropriately in this study and remaining 28.7% were adjusted inappropriately.Findings indicate that dosing errors were common among hospitalized patients with renal impairment. Improving the quality of drug prescription in patients with renal impairment could be of importance for improving the quality of care.