OBJECTIVES:  The cost of antibiotics is always an area of concern in treating RTI. The purpose of the current study was to determine the contribution of costs of antibiotics on the overall prescription costs in paediatric patients. METHODS:  The study was carried out at a pediatric outpatient setting where data of 688 patients, below 18 years of age, was captured over a period of one year from the “Wise-kid” software.  RESULTS: RTI was most common in the age group of 1-3 Y (32%) and 3-6 Y (30%). It affects the patients mostly in winter (35%) followed by autumn (25%). Antibiotic prescribed from NLEM-2011 were found to be 92%. All the antibiotics were prescribed by oral route with brand name only. Percentage of encounters with antibiotics in RTI, were highest in acute otitis media (AOM, 89%), followed by lower respiratory tract illness (LRTI, 76%), tonsillitis (71%), upper respiratory tract infection (URTI) + bronchospasm (17%), URTI (13%) and influenza like illness (ILI, 13%). The average cost of treatment was maximum for AOM (INR186±7; 1USD=approx INR55) followed by LRTI, ILI, URTI (181±11, 125±6 & 120±2, respectively in INR). While the average cost spent on antibiotic treatment was INR 82±8. Of total cost, 17% was spent on the utilization of antibiotics.The order for cost spent on use of different class of drug were cold & cough combinations (37%) > NSAIDs (9%) > nasal drops. The contribution of antiasthmatics, antihistamines & antibiotics was found to be 6% each. Among antibiotics, maximum cost were spent on the use of amoxicillin+clavulanic acid combination (66%) followed by the cost spent on the prescribing of azithromycin, cefpodoxime, clarithromycin, cephalexin & ofloxacin (24%, 4%, 4%, 1.5% & 1% respectively). CONCLUSIONS:  The results indicate that less than 20% costs were spent on antibiotics for the treatment of RTI. These results build the evidence for the cost of treating RTI in children.