ABX resistance among Streptococcus pneumoniae and other respiratory pathogens have been associated with prior ABX. Objective: To examine antibiotic prescribing patterns for different respiratory infections. Study Design: Analyses of linked computerized databases for physician visits and antibiotic prescriptions without identifier information. Methods: In the Canadian province of Saskatchewan, all MD visits are paid through public health insurance. Using ICD9 diagnostic codes, data were obtained on respiratory infections in children less than 5 years of age. Results: In 1995, there were 61,165 children of whom 34,381 (56%) had 94,077 visits with respiratory infections and 40,516 ABX prescriptions. ABX included: penicillins (63.4%), erythromycins (11.8%), cotrimoxazole (5.4%), cephalosporins (7.7%) and erythro-sulfa (6.5%). The most common diagnosis was acute URI, which accounted for 46% of all visits and 42% of all ABX prescriptions. Although mean ABX cost was highest for pneumococcal pneumonia at $20.40, mean cost for treating URI was $12.98. The low rate of ABX for otitis media and pneumonia is likely related to the denominator being visits and multiple visits for each episode, and the inclusion of otitis media with effusion. Conclusion: The rate of ABX prescribing for likely viral infections is not lower than for likely bacterial infections. This confirms ABX over prescribing in Canada as well. The majority of ABX cost is directed at non bacterial infections. Table

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