The monitoring of antibiotic use and bacterial resistance to antibiotics in healthcare facilities (HCFs), a task entrusted to the SPARES initiative since 2018, contributes to the national policy on controlling antibiotic resistance by generating information that supports efforts to promote the appropriate use of antibiotics and prevent cross-transmission. Its objectives are to enable each HC to describe and analyze its consumption and bacterial resistance at the department level, in comparison with a comparable group of HCs, as well as to produce indicators at the regional and national levels. The consumption of systemic antibiotics in class J01 of the Anatomical Therapeutic Chemical (ATC) classification, rifampicin, oral imidazoles, and fidaxomicin, dispensed during inpatient stays, were expressed in defined daily doses (DDD) and adjusted for activity according to national and World Health Organization recommendations (ATC-DDD system, 2024). Resistance rates were expressed by taking into account “resistant” strains. The 1,392 healthcare facilities participating in the antibiotic consumption surveillance program accounted for 71% of hospital days (HD) in France in 2024 (SAE data) and had consumed 322 DDD/1,000 HD. The most commonly used antibiotics were the amoxicillin-clavulanic acid combination (22%), amoxicillin (14%), and ceftriaxone (6%). Antibiotic consumption ranged from 41 DDD/1,000 HD in psychiatric hospitals to 543 in cancer treatment centers. Variations were observed across medical specialties, ranging from 45 DDD/1,000 HD in psychiatry to 1,355 in infectious diseases. Overall antibiotic consumption in 2024 is the highest since 2015. Compared to 2019, total consumption is 13% higher, with a notable increase in the use of broad-spectrum β-lactams (carbapenems, third- and fourth-generation cephalosporins, piperacillin-tazobactam combination), while that of fluoroquinolones has steadily declined, as has that of glycopeptides, in favor of new antibiotics targeting methicillin-resistant Gram-positive cocci (daptomycin, linezolid). The 1,059 healthcare facilities participating in the surveillance of bacterial antibiotic resistance accounted for 58% of hospital days in France in 2024. Among Enterobacteriaceae, 8.2% produced extended-spectrum beta-lactamase (ESBL) with significant variations depending on the clinical specialty (ranging from 4.6% in gynecology and obstetrics to 14.4% in long-term care). The incidence rate of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-producing Enterobacteriaceae) increased to 0.58 strains per 1,000 patient-days in 2024, compared to 0.53 in 2019, with significant variations across clinical sectors. The majority (67%) of the 33,176 ESBL-producing Enterobacteriaceae strains were isolated from urine samples. Among Staphylococcus aureus strains, the percentage of methicillin resistance was 11.4%, with an incidence rate of 0.13 strains per 1,000 patient-days. More than 38% of the 7,545 MRSA strains were isolated from patients hospitalized in medical wards. Data on infections caused by emerging highly resistant bacteria were collected. The incidence rate of carbapenemase-producing Enterobacteriaceae (CPE) was 0.037 strains per 1,000 patient-days; they were most commonly found in urine samples (48.4%), and the most common species was Klebsiella pneumoniae (34.0% of the 1,997 CPB strains). OXA48/48-like strains accounted for 60% of all CPB. Vancomycin-resistant Enterococcus faecium strains were also most frequently isolated from urine samples (36.4% of the 187 strains) and accounted for 1% of the species. Network-based surveillance allows each healthcare facility to analyze its situation, compare itself with others, and identify trends and areas for improvement. Controlling antibiotic resistance requires knowledge and analysis of antibiotic consumption and bacterial resistance data. These data must be supplemented by monitoring indicators of prescription appropriateness as well as by evaluating practices for preventing cross-transmission, particularly in the context of a higher incidence of nosocomial infections.