OBJECTIVES: In the absence of community-based databases on antibiotic use in developing countries recently a methodology was established for surveillance of antibiotic use at New Delhi by conducting ‘Exit Interviews’ of the patients. This study was conducted to obtain information on current prescribing rates of antibiotics in acute respiratory illnesses (ARI), a condition where misuse of antibiotics is common. METHODS: Antibiotic use data was collected from public and private sector facilities from four municipal wards (residential localities) around a tertiary care hospital where the antibiotic resistance work was being conducted. For public sector, 8 dispensaries (primary health care) and 2 secondary care level facilities were enrolled. For private sector, 20 willing and cooperative general practitioners and specialists practising in the chosen areas were selected. Patients after consultation with prescriber were asked if they had cough/common cold/sore throat (symptoms of ARI). Patients with any of these symptoms were enrolled for exit interview and his/her prescription was monitored. Antibiotic use data was collected per month over one year (December 2007-November 2008).The percentage of patients receiving antibiotic and pattern of consumption for various antibiotics was analysed. RESULTS: At public facilities 45.3% (746/1646) and at private facilities 56.7% (259/457) of patients with ARI were prescribed at least one antibiotic. In public sector, macrolides (29.3%), penicillins (26.3%), and cephalosporins (16.2%) and in private sector, cephalosporins (40%), fluoroquinolones (21.7%), and penicillins (19.7%) were mainly prescribed. At public facilities, main members from macrolides were roxithromycin and erythromycin; for penicillins, amoxicillin and amoxicillin+clavulinic acid; for cephalosporins, cefuroxime and cephalexin were used. At private clinics, for cephalosporins, cefuroxime, cefpodoxime proxetil, cefixime, cefixime+clavulinic acid; for fluoroquinolones, levofloxacin and ofloxacin; and for penicillins group amoxicillin+clavulinic acid were prescribed. CONCLUSIONS: Over-prescription and irrational use of antibiotics was seen in ARI. In-depth behaviour study for prescribers and strategies to manage ARI are needed.