OBJECTIVES: Identification of cost–effectivness antibiotic treatment method tonsilopharyngitis and rhynopharingitis accuta in pediatric population from just born to 12 years old children in which these diagnosis were establish on the level of private and government primary health care practice system, depending of clinical report and possible drug hypersensitivity. METHODS: Cost–effectiveness analysis was done in two different periods of time; The first one was before establishing “The National guide for antibiotic treatment", and the second one after that. Four possible treatments with 30 children each were observed. These are following–before the implementation of the National guide 1) Phenoxymethylpenicillin oral suspension (300000 IJ/5ml 10 days); 2) Erythtomycin oral suspension (200mg/5ml 5 days); 3) Benzylpenicilin procainpennicillin inj i.m.( 800000 IJ 7 days); 4) Lincomycin inj i.m (600mg/2ml 7 days). After -1)Amoxicilin+clavulonic acid oral suspension (7 days);2) Azirohromycin oral suspension (200mg/5 ml 4days),3) Benzylpenicillin procainpenicillin inj i.m.;4) Phenoxymethlpenicillin oral suspension. Real costs were calculated for each possible treatment contains direct (first doctor visit, control check up, medicines and OTC therapy costs), indirect (additional treatment payment and eventual complication payment). Patients were sorted in those with completely, partly successful and total unsuccessful treatment. ICER (Incremental cost effectivness ratio) was defined for each possible treatment; base was number of days without refreshing infection. Comparison of ICER value gave cost effectivness therapy. RESULTS: ICER showed for the first period that Benzylpenicillin procainpenicillin inj i.m.(7days) was the best cost effectivness treatment. In addition The National guide confirmed and recommended it also. On the contrary, after implementation of the National guide the most prescribing treatments were Amoxicilin+clavulonic acid oral suspension (7days) and Phenoxymethlpenicillin oral suspension (10 days). It doesn't reduce therapy costs. CONCLUSIONS: Prescribing practice in Serbia should be changed by using the most CE methods and that will cause decrease in total costs of antibiotic therapy.