Background: To compare efficacy of narrow-versus broad spectrum antibiotics in patients aged more than 65 years with AECOPD. Materials & Methods: A total of 100 subjects were enrolled. The study focused on subjects aged 65 and above who were hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and received a minimum of 48 hours of antibiotic treatment. The data was collected and result was analysed using SPSS software. Results: The study involved a total of 100 patients, with 50 individuals assigned to the narrow-spectrum group and another 50 individuals assigned to the broad-spectrum group. The primary combined outcome was observed in 17 patients (34%) from the narrow-spectrum group and in 22 patients (44%) from the broad-spectrum group, showing no significant difference (P = 0.2). Conclusion: The primary outcome among hospitalized individuals aged 65 years and older with AECOPD who were treated with either broad-spectrum or narrow-spectrum antibiotics.