Using antibiotics in hospitals is an important objective to prevent antimicrobial resistance. The classification of antibiotics based on WHO Essential Medicines categorize into Access, Watch, and Reserve (AWaRe) categories can enable interventions which are practical worldwide. Evaluating patterns of AWaRe antibiotic use in pediatrics was our intention this will allow its use in local and national stewardship interventions. Our retrospective observational study included all neonates from County Clinical Emergency Hospital of Oradea, Romania receiving antibiotherapy between 2017-2021. They patients demographics were analyzed which includes (gestational age, birth weight age, and gender), antimicrobial drugs, dose, method of administration, empirical and anticipated management and diagnosis. The WHO methodology and AWaRe classification have been employed in presenting the overall antibiotic prescriptions. The most common prescription of antibiotherapy was neonatal prophylaxis for risk factors of infants, then lower respiratory tract infection and neonatal sepsis. The pattern of antibiotic prescription displays an increasing trend despite the relatively constant number of patients. Gentamycin was the most prescribed antibiotic to hospitalized neonates being associated with ceftriaxone or ampicillin. During the first two years evaluated mainly antibiotics from group Watch were prescribed, while in 2019 and 2020 antibiotics from both categories Access and Watch were prescribed. To improve the control of antibiotic use as a key strategy to reduce antimicrobial resistance and the implementation and monitoring of antimicrobial stewardship actions, AWaRe classification could be used as a simple measure of appropriate antibiotic use. The efforts in the future should focus on developing and evaluating pediatric antibiotic stewardship programs.