Prevalence surveys on antibiotic use in nursing homes for the elderly have revealed a high frequency of broad-spectrum antibiotic use. In EHPAD facilities with an in-house pharmacy (PUI), continuous monitoring of dispensed ATB use—which is easier to implement—could help improve practices. Our objective was to describe ATB use in volunteer EHPAD facilities that participated in the surveillance program of the national mission for the surveillance and prevention of antibiotic resistance in healthcare facilities (SPARES). In 2018 and 2019, data were collected on systemic antibiotics in WHO class J01, as well as rifampicin, oral imidazoles, and fidaxomicin, dispensed by the PUI in nursing home sectors. Quantities were expressed in terms of defined daily doses (DDD, 2019 version), relative to activity measured in number of days of occupancy (DDO). In total, 455 nursing homes reported their antibiotic consumption in 2019, and a cohort of 342 nursing homes participated in 2018 and 2019. In 2019, overall consumption was 37 DDD/1,000 DOP and varied significantly depending on the nursing home’s affiliated facility. The lowest values, around 30 DDJ/1,000 JHeb, were observed in the 7 independent nursing homes, the 15 facilities affiliated with MCO-type healthcare establishments, and the 17 affiliated with a healthcare establishment specializing in psychiatry; the highest values were observed in the 14 nursing homes affiliated with university hospitals (44 DDJ/1,000 JHeb). The most commonly used antibiotics were amoxicillin-clavulanic acid (34%), amoxicillin (28%), and ceftriaxone (6%). In the cohort of 342 nursing homes, overall antibiotic consumption remained stable, with a significant reduction in the use of third-generation cephalosporins (including ceftriaxone, -10%) and fluoroquinolones (-10%). In the absence of individual data analysis via prescription or administration software, monitoring the overall quantities of antibiotics dispensed by hospital pharmacists, according to the national SPARES methodology, provides useful information for raising awareness among healthcare professionals, identifying areas for improvement, and evaluating the impact of measures implemented in nursing homes.