Background: Antibiotic use in acne patients has been associated with an increased risk of upper respiratory tract infection (URTI). Methods: This was a retrospective cohort study using the General Practice Research Database of the United Kingdom. All study subjects were identified as sharing a residence with a patient with a diagnosis of acne. Outcome of interest was a URTI. Results: We identified 98,094 contacts of acne patients. A contact of an acne patient who had a URTI was about 43% more likely to develop a URTI than a contact of an acne patient who did not have a URTI (OR = 1.43 CI = 1.33-1.52, p < 0.001). Exposure to an acne patient using antibiotics did not independently increase a contact's risk of URTI (OR = 0.94, CI = 0.89-1.00, p = 0.063). Conclusions: Although acne patients on antibiotics are about 2 times more likely to develop URTIs, their household contacts do not appear to be at an increased risk of URTI. Copyright (C) 2007 S. Karger AG, Basel.