Patients with acute respiratory tract infections (RTIs) frequently present to primary care clinics. Most of these infections are caused by viruses and are not treatable with antibiotics. Their overuse can result in adverse patient health effects and increase community antibiotic resistance. Antibiotic over-prescribing was suggested by a preliminary study of three Portland Veteran Administration Medical Center (PVAMC) community based outpatient clinics (CBOCs). This retrospective study of the same time period (July 1, 2008 to June 30, 2009), augments that study with the addition of patients who presented with acute (RTIs) at the remaining four PVAMC CBOCs.