Prolonged illness and hospitalization are costly, and the use of expensive first-line antibiotics can further increase cost, making newer antibiotics unaffordable for many governments and patients, especially in developing countries (World Health Organization 2005; Naber 2009). In 1995, the US Congressional Office of Technology Assessment (COTA) estimated that antibiotic resistance costs the United States US $1.3 billion annually (US Congress, Office of Technology Assessment 1995). An Institute of Medicine report estimated that the total cost to society of antimicrobial resistance in the United States was at least US $4 to 5 billion annually (Harrison and Lederberg 1998). Reliable estimates worldwide are not available.

“The next frontier for microbiology may well be determining the causal relationships between infections and a wide range of chronic diseases, from the nation’s biggest health problems, cancer and heart disease, to more obscure ailments.”

 National Institutes of Health/National Institute of Allergy and Infectious Diseases Council News (1999). “Focus is Sharpening on the Role of Microbes and Chronic Diseases.” www.niaid.nih.gov/ncn/newsletters.