According to the German Protection Against Infection Act (IfSG; section 23 paragraph 4, July 2011), hospitals and clinics for ambulatory surgery are obliged to establish a continuous monitoring of antibiotic consumption in their institute. The introduction of the surveillance of antibiotic consumption aims to contribute to an optimization of antibiotic prescription practices in order to confine the development and spread of resistant pathogens. The local public health authority is entitled to supervise the implementation of legal requirements in the hospital setting. The main aim of this article is to support local public health authorities in coping with this task by providing background information on the surveillance of antibiotic consumption and its role as a key component of antibiotic stewardship programs. Furthermore, criteria suitable for assessing the implementation of a functioning surveillance system are proposed. The possibilities and limitations of the activities of public health authorities in this context are addressed.