OBJECTIVES:   To provide a general overview of antimicrobial prescribing cost in a South African primary care patient population whose prescriptions were dispensed by community pharmacies.  METHODS:   A retrospective, cross-sectional pharmacoepidemiological study was conducted on prescription data of a national community pharmacy group in South Africa for 2010.  All records for antimicrobials were analysed.  The MIMS classification system was used.  RESULTS:   A total of 660 500 patients received 1 576 593 antimicrobial products during 2010 (average of 2.39 products per year) at a total cost of R191 875 007.  The average age of patients was 34.23 years.  Most patients were females (58.32%), and they were prescribed 60.12% of antimicrobial products.  The average cost per antimicrobial product was R121.70 (SD=R158.21).  Antiviral agents were the most expensive (R195.67), followed by aminoglycosides (R188.42).  The least expensive products were chloramphenicols (R17.25) and sulphonamides and combinations (R22.68).  Beta-lactams were the most often prescribed class accounting for 36.02% of all antimicrobial prescriptions.  The average cost for a beta-lactam prescription was R99.53.  The average cost per over-the-counter product was R32.75, compared to R158.21 for prescription-only antimicrobials.  Most products were tablets (61.80%), followed by capsules (16.25%) and suspensions (14.39%).  Per prescription, the injections were the most expensive (average of R343.85 per prescription), followed by ampoules (R324.56) and solutions (R267.33).  Creams were on average the least expensive (R31.24).  There was a clear peak in prescribing during the winter months (May to August).  The single most often prescribed trade name product was a generic combination product of amoxicillin and clavulanic acid.  On average, the most expensive trade name product was Valcyte 450R tablets (valganciclovir) at R12 217.76.  CONCLUSIONS:   This study provided a general overview of antimicrobial prescribing cost in a South African primary care patient population.  Costs varied hugely with generic prescribing influencing costs.