The advent of antimicrobial usage in the 1930s provided effective weaponry to combat morbidity and mortality associated with infectious disease. Today, due primarily to inappropriate antibiotic prescribing, these antimicrobial weapons are being seriously threatened by the emerging danger of antimicrobial resistance. Despite guidelines formulated by the Centers for Disease Control and Prevention (CDC) to address judicious antibiotic use in managing pediatric upper respiratory infection, much unnecessary prescribing continues. Many factors contribute to these erroneous practices, including misconceptions held by both the medical community and the public sector. Additionally, patient expectations have an impact on treatment decisions despite advice to the contrary. A review of the literature provides support for the adoption of the CDC standards of care and underlines the need to further investigate practice patterns. Measures to encourage appropriate antibiotic usage and to reverse the trend toward antimicrobial resistance are needed.