This study analyzed the antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a non-teaching (NTH) hospital. These hospitals were chosen to be representative of hospitals in low- and middle-income countries. This study compared the antibiotic prescribing for severe infectious indications for which empiric antibiotic treatment is recommended. This study. This study found the prescribing of watch antibiotics and FDCs of antibiotics increased overtime at both hospitals, indicating under prescribing of access antibiotics and more prescribing of second-choice antibiotics. These results suggest the establishment of antibiotic stewardship programs based in the WHO classification system, along with the implementation of routine diagnostics, could improve antibiotic prescribing.