Rationale: In renal impairment, the pharmacokinetic properties of the drug are altered, and the systemic clearance is reduced. The current study aimed to assess the optimization of antibiotics dosing in renally impaired patients in a healthcare setting. Methodology: A prospective study was conducted on in-patients in the nephrology department, prescribed with antibiotics in a tertiary care hospital. The creatinine clearance was calculated by Cockroft-Gault and Jelliffe method. The dose appropriateness was cross-checked using standard databases and literature from the manufacturer data. Results: Of 139 participants 112 (80.6%) had CKD and 27(19.4%) had AKI. Urinary tract infection was most common. Monotherapy (62) was the most preferred choice, followed by dual in (43) and triple in (7%). A positive clinical outcome of 79.1% was achieved. Cefoperazone-sulbactam was most widely used antibiotic. The mean difference in creatinine clearance was 4.55ml/min in AKI patients. Conclusion: Dose appropriateness is a significant factor in achieving favorable clinical outcomes.