OBJECTIVES: Evaluation of comparative cost-effectiveness of CAP treatment with moxifloxacin versus combined therapy with cefotaxime and macrolides  in adult patients. METHODS: Patients were randomized in two groups.  MOX group received moxifloxacin 400 mg i.v. once-daily with further switch to oral formulation 400 mg daily. COMB group received either cefotaxime 1000 mg i.m. 3 times per day as monotherapy or in combination with oral azithromycin or clarithromycin. Efficacy and safety criteria were evaluated according to clinical data, laboratory tests and X-ray examination. Cost-effectiveness analysis was performed. RESULTS: MOX group included 30 patients, mean age 33.6±16.5 years; COMB group included 50 patients, mean age 26.5±15.6 years. The efficacy of moxifloxacin treatment was 96.7%, in-hospital stay duration was 15.9±3.3 days.   The efficacy of treatment in COMB group was 88.0%, patients were discharged after 18.2±3.7 days. Direct medical costs including antibacterial treatment and in-hospital days were 46712 RUB (€1173) in MOX group and 46970 RUB (€1180) in COMB group. CERMOX = 48307 RUB (€1213), CERCOMB = 53375 RUB (€1340). CONCLUSIONS: CAP treatment with moxifloxacin compared to combined therapy with cefotaxime and macrolides in adult patients  is more effective and cost saving technology.