Background Infection alludes to the invasion and multiplication of either microorganisms or parasites inside bodily tissues. The management of such infections is closely interrelated to the use of antibiotics. Ineffective use of antibiotics is contributed to the antibiotic resistance. Severe disease complications and lengthy hospital stays are among essential reasons why physicians may prescribe myriad types of antibiotics for longer durations. In effort to diminish resistance, the selection of antibiotics ought to be based on information about the bacterial spectrum causing the infection and the patterns of sensitivity to antibiotics. Annual reporting of microbial patterns and sensitivity testing is essential, particularly for pediatric ward patients, as it provides a guide for administering relevant antibiotics and preventing further spread of infections. Objectives This study evaluated microbial patterns, sensitivity test results, and antibiotic resistance among patients in the pediatric ward of RSUP M Djamil Padang from January-December 2020, with a total of 138 samples. Results The proportion of gram-negative and gram-positive bacteria are 83.3% and 16.7%, respectively. The most prevalent gram-negative bacteria are Klebsiella pneumoniae (28.9%), Escherichia coli (26.1%). Pseudomonas aeruginosa (7.9%), Staphylococcus epidermidis (7.2%) and Acinetobacter baumannii (3.7%) also present. These bacteria are predominantly found in samples of feces, urine, and blood. Gram-positive bacteria show notable resistance to the antibiotics such as erythromycin (22.2%), trimethoprim-sulfamethoxazole (19%), and ciprofloxacin (15.8%), while being sensitive to chloramphenicol (17.4%), vancomycin (15.1%), and tetracycline (12%). In contrast, gram-negative bacteria exhibit resistance to ampicillin (16.5%), ceftriaxone (12.1%), and ceftazidime (11.3%), but are sensitive to amikacin (19.8%), meropenem (19.4%), and gentamicin (10.9%). Keywords: microbial patterns, antibiotic sensitivity, pediatric ward