Objectives: To analyze the structure of direct treatment costs for FUO and identify key cost-driving factors. Methods: A retrospective pharmacoeconomic analysis using a bottom-up approach was conducted on 71 patients treated for FUO at the Clinic for Infectious Diseases, University Clinical Centre Kragujevac, between 2016 and 2022. Treatment cost data were extracted from the electronic medical records. Results: The total direct cost was €81,655.20, with a mean of €1,150.07 ± 3,434.60 per patient with a median of €549.55 (IQR=€512.62). Major cost components included pharmacotherapy (49.40 %; €40,337.26), diagnostic procedures (30.52 %; €24,923.44), and hospitalisation (10.32 %; €8,324.00). Significant cost determinants were the following: gender, the Charlson comorbidity index, hospital stay duration, number of medications administered per patient, and number of specialist consultations. Conclusions: Pharmacotherapy, especially broad-spectrum antibiotics and antifungals, along with diagnostics and hospitalisation, are the main contributors to FUO treatment costs. Patient-specific factors, particularly comorbidities and service utilisation, play a significant role in determining overall healthcare expenditure.

Isotretinoin is an oral medicine prescribed for the management of severe acne that is insensitive to conventional therapy, including systemic antibiotics. Acute psychosis refers to a severe mental illness characterized by a loss of touch with realism, visions, delusions, confused thinking, and abnormal behaviors. The study aims to analyze and document these cases to better understand the potential relationship between isotretinoin use and the development of acute psychosis, as well as to find out which therapy is best for treating this problem. We searched the following electronic databases independently with no linguistic or date limit: PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and Serbian Citation Index (SCIndeks). Our results included 14 studies (13 case reports and 1 cohort study) with 18 individual cases. The oldest patient was 27 years old, and the youngest was 13 years old. Both genders were represented with 9 individuals each. We can conclude that, in addition to discontinuation of isotretinoin, therapy with olanzapine and eventually risperidone could improve the symptoms of psychosis caused by isotretinoin.