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Abstract Introduction: The use of antibiotics needs to be monitored. Its irrational use causes antibiotic resistance. Research needs to be done that aims to determine trends in antibiotic use. Methods: Observational research with retrospective data collection. Cross sectional research design. Data in the form of availability of antibiotics during the period 2014 - 2017 in hospitals, health offices and health centers in the city of Manado. Results: The trend of the use of antibiotics in the first level of health facilities in 2014 - 2017 in the city of Manado was the antibiotics of betalactam, macrolide, sulfamethoxazole-trimethoprim, quinolone groups. Trends in second-grade health facilities are the betalactam antibiotics, sulfamethoxazole-trimethoprim and quinolones. Trend in third-level health facilities are betalactam antibiotics, quinolones and others. Conclusion: Based on the data of 5 major antibiotic use in level 1, 2 and 3 health facilities, there was a change in the pattern of antibiotic use and this pattern tended to increase.