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Background Amoxicillin-clavulanic acid is one of the most prescribed antimicrobial combinations in India. However, data on its real-world prescribing trends, effectiveness, and safety remain limited. Objective To evaluate prescribing patterns, dosing practices, adjuvant use, clinical effectiveness, and adverse drug reactions (ADRs) associated with Amoxicillin-clavulanic acid across Indian healthcare settings. Methods A retrospective, questionnaire-based multicentric study was conducted using anonymized data from 30,654 patients prescribed Amoxicillin-clavulanic acid under protocol IND/ACL/01. Parameters assessed included demographics, indications, prescriber specialty, dose, duration, adjuvant use, and outcomes. Descriptive statistics were applied. Results Among the analyzed prescriptions, upper respiratory tract infections (52.4%) and lower respiratory tract infections (19.5%) were the most common indications, followed by urinary tract infections (10.0%), <i>Helicobacter pylori (H. pylori)</i>-associated gastritis (6.8%), skin and soft tissue infections (5.0%), and dental infections (3.0%). Clinical resolution was achieved in 82.5% of patients, with effectiveness particularly notable in respiratory and dental infections. Adverse drug reactions, mostly mild gastrointestinal symptoms such as diarrhea and nausea, were reported in 21.6% of cases. Treatment duration averaged 7.5±2.8 days, with shorter courses showing similar clinical success. The most common regimen was amoxicillin-clavulanic acid 500/125 mg twice daily for seven to 10 days. Proton pump inhibitors (PPIs) were co-prescribed in 53.9% of cases, mainly rabeprazole, along with probiotics (23.3%). Conclusions Amoxicillin-clavulanic acid demonstrated high clinical effectiveness across common indications such as respiratory tract infections, urinary tract infections, skin and soft tissue infections, as well as in dental infections and <i>H. pylori</i>-associated gastritis. Clinical resolution was achieved in over 80% of cases, with a favorable safety profile characterized mainly by mild gastrointestinal adverse events in about 20% of patients. These real-world results underscore its valuable role in diverse Indian healthcare settings, supporting evidence-based prescribing for optimized outcomes.