Antibiotic resistant bacteria are a significant problem of public health importance, and are responsible for substantial hospital morbidity, mortality and cost. Estimates of cost vary, however, depending on the organism of interest, the study design and other factors. Most previous cost studies focused on antibiotic resistance as it impacts healthcare facility costs. Differences in design and methods make comparisons between these studies difficult, and there are clear limitations in the methodology frequently used in these analyses. Significant improvement is needed in studies of the cost of antimicrobial resistance, including more rigorous design and analytical methods, to generate more reliable estimates of the real cost of antibiotic resistance. Collaboration with economic experts will aid in producing more accurate cost estimates that can be used to guide healthcare administration decisions and resource utilization.