Allocation of the resources in health care and finding a way how to prioritize spending within health care systems are hot issue, even in the developed countries. Introduction of new medical products and technologies is one important driver for increased health care costs. COPD is among top five causes of morbidity and mortality worldwide. The aim of this study is to evaluate cost effectiveness of antimicrobial regiments for treatment of acute exacerbation of COPD. Cost effectiveness analysis was performed based on data from two published observational, "real world" studies carried in Institute for occupational Health of Macedonia. Methodology is based on calculation of ICER in as many steps as needed until all exclusion criteria`s are met. All ICER`s are interpreted using cost effectiveness plane. Amoxicillin with clavulanic acid and cefuroxime dominated over other antibiotic regiments. Doxycycline, cefuroxime, cefpodoxime and moxifloxacin are cost-effective alternatives. When deciding, size of the available budget and patient's willingness to pay will be key factors. The results of this study provide data and useful information which antibiotic will give best expected outcomes, with least produced costs.

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