Background: Farm-level antimicrobial stewardship in swine production requires indication-specific knowledge of treatment patterns and the herd-level features associated with them. Methods: We analyzed questionnaire-based data collected in 2015 from 13 Hungarian swine farms covering 15,725 sows and their progeny. The survey captured production indicators, pathogen occurrence, vaccination, resistance-testing practices, drug costs, and disease-group-specific antimicrobial use. As a separate, non-mergeable descriptive temporal comparator, we also considered independent digital farm-monitoring data from three large-scale swine herds from 2022 to 2024. Results: The most frequently reported pathogens were Mycoplasma hyopneumoniae (13/13 farms), Lawsonia intracellularis (12/13), Escherichia coli (12/13), swine influenza virus (11/13), and Streptococcus suis (10/13). S. suis ranked as the leading damaging pathogen on 69% of farms. Among farms with antibiotic cost data (9/13), antibiotics accounted for a mean of 31.8% of veterinary drug expenditures. Among farms with treatment-by-indication data (8/13), the highest relative frequency of reported treatment events was linked to porcine respiratory disease complex, where doxycycline represented 38% of reported PRDC treatment events. Colistin dominated E. coli-associated diarrhea control, whereas beta-lactams were central for S. suis-related disease. In the 2022–2024 comparator dataset, enteric and respiratory disorders and arthritis remained the main recorded health problems, but corrected antimicrobial use was markedly lower in the later dataset. Conclusions: Antimicrobial use showed clear disease-group-specific patterns, supporting syndrome-focused stewardship rather than generic reduction targets.