BACKGROUND: The aim of this study was to estimate trends in primary care consultations and antibiotic prescribing for acute respiratory tract infections (RTIs) in the UK from 1997 to 2006. METHODS: Data were analysed for 100,000 subjects registered with 78 family practices in the UK General Practice Research Database; the numbers of consultations for RTI and associated antibiotic prescriptions were enumerated. RESULTS: The consultation rate for RTI declined in females from 442.2 per 1000 registered patients in 1997 to 330.9 in 2006, and in males from 318.5 to 249.0. The rate of consultations for colds, rhinitis and upper respiratory tract infection (URTI) declined by 4.2 (95% CI 2.3-6.1) per 1000 per year in females and by 3.6 (2.3-4.8) in males. The rate of antibiotic prescribing for RTI was higher in females and declined by 8.5 (2.0-15.1) per 1000 in females and 6.7 (2.7-10.8) in males. For colds, rhinitis and URTI, the proportion of consultations with antibiotics was prescribed declined by 1.7% per year in females and 1.8% in males. CONCLUSIONS: Decreasing frequency of consultation and antibiotic prescription for colds, rhinitis and 'URTI' continues to drive a reduction in the rate of antibiotic utilization for RTIs.