BACKGROUND: There are significant concerns about emerging antibiotic resistance that are largely due to the inappropriate use of antibacterial agents for viral respiratory infections. We explored clinicians' attitude on antibiotic prescription for patients with respiratory tract infections (RTIs) using survey. METHODS: A random, stratified sample of physicians in Seoul, Gyeonggi, and Incheon was surveyed with a mailed questionnaire, and 353 clinicians completed information. A total of 344 were included in the final dataset after excluding incomplete data with missing information (response rate 34.4%). RESULTS: Among 344 physicians, those who would prescribe antibiotics in scenario patient were 39.2%, wait and prescribe 30.5% and not prescribe antibiotics 30.2%. Those who believed antibiotics would help treatment of acute sinusitis were 83.7%, acute pharyngitis 36%, acute tonsillitis 86.3%, acute bronchitis 64% and acute lower respiratory diseases 66.9%. In logistic regression analysis, those who were located in Gyeonggi region and those who believed antibiotics help treatment of tonsillitis and suppurative otitis media would prescribe antibiotics in scenario patient significantly more, whereas those who believe antibiotics help treatment of acute pharyngitis and lower respiratory disease prescribe antibiotics less. CONCLUSIONS: Physicians' attitude to antibiotics in respiratory disease has a significant effect on antibiotic prescription for RTIs. Interventions such as practice guidelines and patient education to optimize antibiotic prescription should take this effect into account.