Background: The intensification of pig production systems has been associated with increased antimicrobial use (AMU), which remains a key driver of antimicrobial resistance (AMR) and a major concern for both veterinary and public health sectors. Monitoring and rationalizing antibiotic usage are crucial to prevent the selection of resistant bacterial strains that pose risks to both animal and public health. Objectives: The aim of this study was to assess the structure and magnitude of antibiotic use as well as related reduction strategies, in three large-scale Hungarian swine herds, based on farm data recorded between January 2022 and June 2024. Materials and Methods: Data were collected using a digital herd health monitoring system covering monthly animal health cases and antibiotic usage. Antibiotic use was evaluated by AMEG classification, active ingredient groups, route of administration (e.g. water, feed, injection), treatment type (therapeutic vs. metaphylactic) and age group (e.g. sows, weaners, fatteners). Quantitative indicators included total mass (mg) and mg/PCU values. Results and Discussion: Antibiotic use declined during the study period, particularly in weaned pigs by 87.6% (corrected mg/PCU: from 341.70 to 42.35). The most frequent clinical problems on the examined farms were enteric and respiratory disorders as well as arthritis. Drinking water medication remained dominant (93.8%), though individual treatments increased in frequency. In 2023, a major shift occurred toward targeted therapeutic use (83.7%) over metaphylaxis (16.3%). The increased proportion of AMEG C category antibiotics and reduced use of AMEG D category substances indicate changing prescribing patterns. Regular treatment logs, vaccination protocols, sensitivity testing and the use of organic acids and probiotics may contribute to a more prudent antibiotic approach. These results confirm the importance of diagnostics-driven treatment and farm-specific interventions in AMR mitigation.