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The objective of this study was to determine the extent and characteristics of telephone\u2010based antibiotic prescribing in teaching and non\u2010teaching primary care practices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study included all patients (<jats:italic>n<\/jats:italic>\u2009=\u2009114\u2009610) cared for by teaching and non\u2010teaching internal medicine, pediatrics, family practice, and obstetrics\/gynecology practices (<jats:italic>n<\/jats:italic>\u2009=\u200919) affiliated with a large US healthcare system during 2006\u20132010 and using a common electronic medical record. Rates and types of antibiotics prescribed by teaching and non\u2010teaching practices via telephone contact and office visit were compared among the overall cohort. All telephone\u2010related prescriptions during 2008 underwent chart review to determine indications for antibiotic prescribing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 28.9 antibiotic prescriptions were issued per 100\u2009patient\u2010years, with 63\u2009418 total antibiotic prescriptions and 7876 (12.4%) generated after telephone contact. Telephone\u2010based prescribing increased steadily from 2.2 to 4.2 per 100\u2009patient\u2010years during the study period. Both telephone\u2010based and office\u2010based antibiotic prescribing were higher in non\u2010teaching practices. Of 1790 antibiotics prescribed by telephone during 2008, the majority were for urinary tract infection (28.3%), sinusitis (20.1%), and unspecified upper respiratory infection (URI, 15.0%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, one in every eight antibiotics was prescribed via telephone encounter. These data highlight the need to include the impact of this practice in analysis of outcomes associated with outpatient antibiotic prescribing and to incorporate telephonic prescribing into guidelines facilitating appropriate antibiotic use. 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