OBJECTIVES: Determine the use of antibiotics and prescription medication in primary care in the management of influenza, stratified by age, risk and complications. METHODS: A cross-sectional observational study was carried out using data derived from GPRD, (January 2001 - March 2009). Subjects included were: all those with general practitioner (GP) coded episodes of care for acute respiratory events related to infection (influenza and Influenza-like-illness). Analysis was stratified by age and ‘at-risk’ status recommended for influenza vaccination in the UK. Primary prescription information was collected for the following categories: antipyretics/analgesics, antibiotics, amantadine, aminoglycosides, nasal decongestants, antisecretory drugs and mucosal protectants, and  antihistamines. UK 2011 NHS reference costs were used. RESULTS: 53% of all patients had at least one medical prescription with 30% of patients receiving antibiotics. Proportionally more patients with complicated influenza had prescriptions (83%) compared to patients with uncomplicated influenza (50%), and most cases were unvaccinated. Across all age groups complicated influenza had a greater number of prescriptions compared to those with uncomplicated cases (3.0 vs. 2.5). 67% and 27% of complicated and uncomplicated influenza cases received antibiotics. Antipyretics and analgesics were prescribed to 7% of patients, with antisecretory drugs and mucosal protectants prescribed to 6% of patients.  Antibiotics, analgesics and antisecretory drugs (including mucosal protectants), were the three most commonly prescribed classes of drugs, and represent 41%, 31% and 12% of all prescriptions respectively. The annual cost is expected to be around £13,956,177 per annum with 40% of this cost attributable to antibiotics. CONCLUSIONS: In-hospital and over-the-counter medication use is not collected in this database, therefore this is not a comprehensive assessment of the full extent of pharmaceutical management of influenza. The extensive use of antibiotics prescribed by GPs is of concern, especially in uncomplicated influenza episodes at a time of increasing resistance. Current clinical practice therefore needs urgent review.