OBJECTIVES: According to the recent international data, the incidence of bloodstream catheter - associated infections is 3-8% in the structure of hospital- acquired infections in the intensive care units (ICU) and the leading cause of them are Gram positive bacteria. In this study we conducted comparative analysis of clinico - economic effectiveness of daptomycin (dapto) vs vancomycin (vanco) usage in treatment of patients with MRSA catheter - associated infection in the ICU.  METHODS: “Decision Tree” pharmacoeconomic model was built based on results of international clinical studies and data of routine practice treatment of bloodstream infections in Moscow clinics. Two variants of antibacterial treatment of patients with catheter-associated infections differing on starting products (dapto or vanco) were assessed. If the first line of therapy was ineffective, patients switched over to the second line therapy covering resistant strains - meropenem and fluconazole. Direct and indirect medical costs were assessed: cost of antibiotics and additional medical treatment, antibacterial diagnostic, laboratory and cost of bed-days in ICU and therapeutic   department. Costs were based on official data on hospital medical service in municipal Moscow clinics and purchasing price on medical products from price list of the biggest Russian pharmaceutical distributors. Clinical recovery was considered as efficacy with the goal to evaluate cost-effectiveness ratio (CER) of two groups (CERdapto and CERvan accordingly).  RESULTS: Better clinical efficacy in daptomycin group resulted in lower – needs to change antibiotic in catheter - associated infection treatment in the ICU in comparison to vancomycin group. In spite of the higher price of drug, average cost of successfully treated patient by daptomycin (CERdapto) was 227,887 RUR/pt in compare with CERvan  235,032 RUR/pt. Exchange rate is 1USD = 30 RUR.  CONCLUSIONS: Good cost-effectiveness ratio in comparison to vancomycin supports use of daptomycin as the first line antibacterial therapy in bloodstream catheter - associated infections.