The prevalence and the antimicrobial susceptibilities of bacterial pathogens in acute upper respiratory tract infections (AURTIs) is not clear. We conducted a prospective community-based multicenter study in 45 centers across Nagasaki, Japan, between December 2001 and April 2002. We examined the nasopharyngeal or throat isolates in 930 adult outpatients with AURTIs. Potential bacterial pathogens, including Streptococcus pyogenes (from 6.8% patients), S. pneumoniae (5.3%), S. milleri group (2.0%), Staphylococcus aureus (26.0%), Moraxella catarrhalis (7.4%), Haemophilus influenzae (17.6%), and Klebsiella pneumoniae (1.2%), were isolated from 51.8% of the patients. Penicillin nonsusceptible phenotype accounted for 44.9% of S. pneumoniae isolates. Among Staphylococcus aureus isolates, 9.1% were methicillin-resistant. In H. influenzae isolates, 6.7% produced beta-lactamase and 23.2% were beta-lactamase-negative ampicillin-resistant. The results indicated that the potential bacterial pathogens were detected in the remarkable population of the adults with AURTIs and the current antimicrobial susceptibilities of such pathogens.