The study investigated the chemokine CXCL8 in 2023 elderly patients (≥65 years) with bacterial upper respiratory tract infections (BURTI) and 42 healthy controls. Blood CXCL8 levels at admission were higher in the observation group than in the control group (89.67 ± 8.33 pg/ml vs. 71.20 ± 8 pg/ml, p < 0.05). After treatment, the levels decreased and patients with relapse had higher values than those without relapse (78.44 ± 8.84 pg/ml vs. 69.67 ± 5.51 pg/ml, p < 0.05). ROC curve analysis showed good diagnostic value of CXCL8 for BURTI and prognostic recurrence (AUC = 0.788). CXCL8 is elevated in elderly patients with BURTI and is a good predictor of both incidence and risk of recurrence. The findings suggest CXCL8 as a potential biomarker for personalized therapy, but it requires further validation with clinical scores.