The monitoring of antibiotic use in healthcare facilities, a task entrusted to the Spares initiative since 2018, contributes to the national policy on controlling antibiotic resistance by promoting the appropriate use of antibiotics. Its objectives are to enable each healthcare facility to describe and analyze its antibiotic use, at the department level, in comparison with a comparable group of healthcare facilities. HCFs are also encouraged to monitor bacterial resistance and compare it with consumption data. 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 reported based on activity according to national and World Health Organization recommendations (ATC-DDD system, 2019). The 1,630 participating healthcare facilities accounted for 73% of hospital days in France in 2018 and had consumed 288 DDDs per 1,000 hospital days (HD). The most commonly used antibiotics were the amoxicillin-clavulanic acid combination (26%), amoxicillin (13%), and ceftriaxone (7%). Antibiotic consumption ranged from 43 DDD/1,000 HD in psychiatric hospitals to 577 in military hospitals. Variations were observed across specialties, ranging from 42 DDD/1,000 HD in psychiatry to 1,419 in infectious diseases. Since 2012, a significant number of healthcare facilities have participated each year (1,411 in 2012 and 1,630 in 2018), allowing for the following trends to be extrapolated: an overall decline in antibiotic consumption since 2012 (-6.7%), with a sustained decrease beginning in 2016; an increase in the use of carbapenems, third-generation cephalosporins, and the piperacillin-tazobactam combination; a reduction in the use of fluoroquinolones and glycopeptides, in favor of new antibiotics targeting methicillin-resistant Staphylococcus aureus (MRSA). Network-based surveillance, using the ConsoRes tool, enables each healthcare facility to analyze its situation, compare itself with others, exchange information on practices and organizational structures, and identify trends. 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.