Background: France and the Netherlands are often presented as two contrasting countries with regard to drug prescriptions and consumption. This study aimed to analyse general practitioners’ (GP's) prescription patterns for upper respiratory tract infections (URTI). Methods: Data on diagnoses and prescriptions were derived from two databases recording daily electronic medical patient files: the ‘Société Française de Médecine Générale’ database (SFMG-DB) and the Dutch Landelijk Informatie Netwerk Huisatsenzorg database (LINH-DB). Logit regression models were developed to estimate and compare prescription patterns in both countries. We carried out a study including all the patients consulting for URTI in 2003. Results: French GPs had more URTI patients than their Dutch counterparts (372.1 URTI patients/GP versus 181.3). They prescribed higher volumes of URTI medications (3.55 per patient/year versus 0.82). Striking differences were observed in analgesic and symptomatic prescriptions (0.84 per patient/year versus 0.12 and 1.01 per patient/year versus 0.21, respectively). We did not observe important discrepancies in volume of antibiotic prescriptions (0.29 per patient/year in France versus 0.32). After adjustment for patient characteristics, the logit model showed that prescription patterns for antibiotic were quite similar and associated with a diagnosis of acute tonsillitis. Conclusion: The analysis per consultation in this study did not highlight important differences in antibiotic prescribing volumes and patterns. But symptomatic and analgesic prescriptions were significantly higher in the French database. This can be explained by differences in help-seeking behaviour, medication perception, status of OTC medications and remuneration system.