OBJECTIVES: Antibiotics have made a significant contribution to improving patient health, but policy makers and health care payers are concerned about the costs of antibiotics in addition to their effectiveness. This study aims to assess the value of antibiotics by examining published incremental cost-utility ratios of antibiotics. METHODS: Evidence was derived from cost-utility analyses of antibiotics included in the Tufts-New England Center Cost-Effectiveness Analysis Registry through September 2009. For each cost-utility analysis, the following variables were examined: publication year, target population, intervention type, country of patient sample, disease classification, prevention stage, funding source, study perspective, discounting, sensitivity analysis, incremental cost-utility ratio, and methodological quality. Evidence of the value of antibiotics was summarized by calculating median incremental cost-utility ratios and frequency distributions. Associations between incremental cost-utility ratios on the one hand and the prevention stage, study perspective and methodological quality were examined by means of the Mann-Whitney U-test for ordinal variables. RESULTS: The analysis included 85 incremental cost-utility ratios from 23 cost-utility analyses. The findings showed that 38.8% of incremental cost-utility ratios related to dominant antibiotics; 45.9% referred to antibiotics that improved effectiveness, but also increased costs; and 15.3% related to dominated antibiotics. The median ratio was €748 per quality-adjusted life year. Using threshold values of €20,000 per quality-adjusted life year and €50,000 per quality-adjusted life year, the probability that an antibiotic provides value for money was 64% and 67%, respectively. No statistically significant association was observed between incremental cost-utility ratios and the prevention stage (p = 0.119), study perspective (p = 0.285) or methodological quality (p = 0.146). CONCLUSIONS: The current evidence base suggests that the majority of antibiotics provide value for money.