Background: Antibiotics are the most commonly prescribed drugs in pediatrics, which focuses on the medical treatment of newborns, children, and adolescents. Understanding and monitoring antibiotic prescribing patterns are crucial to ensuring their appropriate use, maximizing their benefits and minimizing harm. Cost minimization analysis is an effective tool for evaluating cost-effective strategies in pediatric healthcare. Methodology: This prospective observational study was conducted over ten months at Parul Sevashram Hospital, Vadodara, Gujarat. Following institutional ethics committee approval, 155 participants were enrolled based on the study-specific inclusion criteria. Data collected from the participants were evaluated against the WHO core prescribing indicators. A cost minimization analysis was performed on the antibiotic data. Statistical analyses were conducted using MS Excel and GraphPad Prism, and the findings were presented through percentages, tables, and graphical formats. Results: Our study involving 155 participants at Parul Sevashram Hospital, Vadodara, observed a higher proportion of males (65.16%) compared to females (34.84%). Most of the participants were aged 2 to 11 years (60.65%). Amoxicillin and Potassium Clavulanate were the most commonly prescribed antibiotics, with E. Coli being a prevalent pathogen. Polypharmacy was evident, with an average of 10.87 medications per prescription and many patients receiving more than three antibiotics. Injectable antibiotics were frequently used, though generic prescribing was below the WHO recommendations. The cost analysis revealed a significant price difference of 26% between the prescribed brands (INR 572,929.14/USD 6,851.20) and the suggested brands (INR 425,329.61/USD 5,086.05). This highlights the importance of cost-effective antibiotic choices. Conclusion: This study analyzed the antibiotic use in pediatric patients, focusing on the WHO's core indicators and pharmacoeconomic factors. It highlights polypharmacy and the prevalence of parenteral antibiotic treatment. Despite using generic names, the hospital does not meet the WHO's recommended range of antibiotics. A cost minimization analysis revealed significant differences between the prescribed and suggested brand formulations, highlighting opportunities for cost savings through generic or recommended substitutes.