OBJECTIVES: Nosocomial pneumonia (NP) is the second most common cause of in-hospital infection and the leading cause of death from infections acquired in hospitals commonly caused by methicillin resistant Staphylococcus aureus (MRSA). This study aims to evaluate clinical and economic outcomes related to NP treatment with linezolid versus teicoplanin and vancomycin from a private and public payer’s perspectives in Brazil. METHODS: A decision-tree model simulates NP treatment with linezolid (600mg bid, 19 days), teicoplanin (400mg bid, 22 days), and vancomycin (15mg/kg bid, 24 days) and their associated costs in a time horizon of complete hospital care. After a first evaluation patients with response continued with maintenance treatment and those with failure switched to a second treatment. Efficacy data (clinical response) was generated by meta-analysis based on systematic literature review. Costs included drugs, medical follow-up and adverse events management, collected from Brazil official databases (values represented 2013 BRL). RESULTS: Clinical response, days on ward, and intensive care unit (ICU) days were [72.6%; 7; 12], [68.3%; 8; 14], and [66.5%; 8; 16] for linezolid, teicoplanin, and vancomycin, respectively. Total treatment costs with linezolid, teicoplanin, and vancomycin were 49,426.43BRL, 79,710.87BRL and 81,352.99BRL from the private perspective and 15,213.60BRL, 13,884.51BRL, and 24,348.44BRL from the public perspective, respectively. Linezolid represented the least costly in private perspective (economy of 30,284BRL and 31,927BRL when compared to teicoplanin and vancomycin). The main cost driver for all treatments was related to daily in ICU followed by adverse events management (teicoplanin and vancomycin) and drug acquisition (linezolid). CONCLUSIONS: In this analysis, linezolid in NP management presented the greatest clinical response, shorter hospital stay in ward and ICU, and lower price when compared to teicoplanin and vancomycin in Brazilian private healthcare system and lower price when compared to teicoplanin in public set.