| Summary: | We followed up the interplay between antibiotic use and resistance over time in a tertiary-care hospital in Hungary. Dynamic relationships between monthly time-series of antibiotic consumption data (defined daily doses per 100 bed-days) and of incidence densities of Gram-negative bacteria (<i>Escherichia coli</i>, <i>Klebsiella</i> spp., <i>Pseudomonas aeruginosa</i>, and <i>Acinetobacter baumannii</i>) resistant to cephalosporins or carbapenems were followed using vector autoregressive models sequentially built of time-series ending in <i>2015</i>, 2016, 2017, 2018, and 2019. Relationships with Gram-negative bacteria as a group were fairly stable across years. At species level, association of cephalosporin use and cephalosporin resistance of <i>E. coli</i> was shown in 2015–2017, leading to increased carbapenem use in these years. Association of carbapenem use and carbapenem resistance, as well as of carbapenem resistance and colistin use in case of <i>A. baumannii</i>, were consistent throughout; associations in case of <i>Klebsiella</i> spp. were rarely found; associations in case of <i>P. aeruginosa</i> varied highly across years. This highlights the importance of temporal variations in the interplay between changes in selection pressure and occurrence of competing resistant species.
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