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, relative to a comparable group of HCs, as well as to produce indicators at the regional and national levels. Systemic ATBs 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 in accordance with national and World Health Organization recommendations (ATC-DDD system, 2021). Resistance rates were expressed by taking into account "resistant" and "intermediate" strains. The 1,752 healthcare facilities (1,734 in 2019) participating in the antibiotic consumption surveillance program accounted for 81% of hospital days in France in 2020 and had consumed 286 DDDs per 1,000 hospital days (HD). The most commonly used antibiotics were the amoxicillin-clavulanic acid combination (24%), amoxicillin (12%), and ceftriaxone (7%). Antibiotic consumption ranged from 38 DDD/1,000 HD in psychiatric hospitals to 590 in cancer treatment centers. Variations were observed across different sectors, ranging from 38 DDD/1,000 HD in psychiatry to 1,145 in intensive care. In a cohort of 1,092 healthcare facilities that participated in 2019 and 2020, an increase in overall antibiotic consumption was observed (+2.1%), linked to increased consumption of certain antibiotics: carbapenems, third-generation cephalosporins, and piperacillin-tazobactam. The use of fluoroquinolones decreased, as did that of glycopeptides, in favor of new antibiotics targeting methicillin-resistant Staphylococcus aureus (MRSA). In 2020, the consumption of broad-spectrum antibiotics and macrolides was higher than in 2019, against a backdrop of reduced scheduled procedures and the admission of COVID-19 patients. The 1,066 healthcare facilities (991 in 2019) participating in the surveillance of bacterial antibiotic resistance accounted for 53% of hospital days in France in 2020. Among Enterobacteriaceae, 8.3% produced extended-spectrum beta-lactamases (ESBLs), with significant variations by clinical specialty (ranging from 2.7% in gynecology and obstetrics to 17.6% in long-term care). Nearly two-thirds of the 31,486 ESBL-producing strains were isolated from urine specimens. Among Staphylococcus aureus strains, the percentage of methicillin resistance was 14.0%. More than 40% of the 9,221 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 (41.1%), and the most prevalent species was Klebsiella pneumoniae (37.8% of the 566 CPE strains). Vancomycin-resistant Enterococcus faecium was also most frequently isolated from urine specimens (46.5% of the 99 strains). In cohorts of facilities that participated in surveillance in 2019 and 2020, a decrease in the incidence density (ID) of MRSA-positive samples (0.19 vs. 0.17) and an increase in the ID of VRE (0.55 vs. 0.59) were observed. Network-based surveillance, using the ConsoRes tool, 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.