The monitoring of antibiotic use and bacterial resistance to antibiotics 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 and preventing 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 reported based on activity according to the World Health Organization’s national recommendations (ATC-DDD system, 2021). Resistance rates were expressed by taking into account "resistant" and "intermediate" strains. The 1,717 healthcare facilities participating in the antibiotic consumption surveillance program accounted for 82% of hospital days in France in 2021 and had consumed 282 DDDs per 1,000 hospital days (HD). The most commonly used antibiotics were the amoxicillin-clavulanic acid combination (22%), amoxicillin (13%), and ceftriaxone (7%). Antibiotic consumption ranged from 36 DDD/1,000 HD in psychiatric hospitals to 530 in cancer treatment centers. Variations were observed across different specialties, ranging from 36 DDD/1,000 HD in psychiatry to 1,153 in infectious diseases. Across all healthcare facilities that participated at least once between 2012 and 2021, overall antibiotic consumption decreased (-8.6%). The use of fluoroquinolones, in particular, has steadily declined. The use of glycopeptides has decreased since 2015, in favor of new antibiotics targeting methicillin-resistant Staphylococcus aureus (MRSA). Over the period, the use of broad-spectrum beta-lactams (carbapenems, third- and fourth-generation cephalosporins, piperacillin-tazobactam combination) increased. The 1,010 healthcare facilities participating in the surveillance of bacterial antibiotic resistance accounted for 54% of hospital days in France in 2021. Among Enterobacteriaceae, 7.5% produced extended-spectrum beta-lactamases (ESBLs), with significant variations by clinical specialty (ranging from 3.1% in gynecology and obstetrics to 15.6% in long-term care). Two-thirds of the 28,295 EBLSE strains were isolated from urine specimens. Among Staphylococcus aureus strains, the percentage of methicillin resistance was 12.3%. More than 40% of the 8,227 MRSA strains were isolated from patients hospitalized in medical wards. Data on infections caused by emerging highly resistant bacteria were collected. Carbapenemase-producing Enterobacteriaceae (CPE) were most commonly found in urine specimens (49.1%), and the most prevalent species was Klebsiella pneumoniae (34.4% of the 823 CPE strains). Vancomycin-resistant Enterococcus faecium was also most frequently isolated from urine samples (61.5% of the 103 strains). - Network-based surveillance allows each healthcare facility to analyze its own 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.