OBJECTIVE: To compare the efficacy and economic outcomes related to the treatment of acute bacterial exacerbation of chronic bronchitis in adult patients treated with either: 1) cefpodoxime proxetil 100mg, or 2) cefpodoxime proxetil 200mg twice daily for 14 days. METHODS: The cefpodoxime proxetil arms of a multi-center, randomized, observer-blinded, parallel-group antibiotic trial were evaluated. A total of 117 patients completed the study (100mg n=58, 200mg n=59). Direct and indirect costs related to the infection and its treatment were collected over the course of the study, including additional office visits, lab tests and procedures, and indirect costs related to productivity changes at work and social hours lost due to the illness. RESULTS: There were no significant differences between the 100mg and 200mg groups with regards to bacterial cure rates (89.7 and 89.8 percent, respectively), mean percent of total work hours lost [16.91 (15.67) and 20.47 (27.41), respectively (p=0.597)], and mean percent of total social hours lost [10.71 (12.69) and 9.55 (9.67), respectively (p=0.690)]. Furthermore, there were no practical differences in the additional health care utilization and number of medical events related to the drug therapy. Mean study medication costs were significantly lower (p<0.001) for the 100mg group [$66.70 ($6.80)] when compared to the 200mg group [$93.80 ($5.72)]. CONCLUSIONS: Because there were no significant differences in the clinical outcomes, additional health utilization and medical events, and work and social hours lost when comparing the two treatment regimens, the use of cefpodoxime proxetil 100mg provided cost-minimization over cefpodoxime proxetil 200mg in the treatment of acute bacterial exacerbation of chronic bronchitis in adult patients.