Background: Excessive use of glycopeptide antibiotics may enhance the risk of glycopeptide resistance among enterococci and staphylococci, but there is little data on the use of these antibiotics in German hospitals. Methods: Hospital pharmacy records for the years 1992 to 1994 were evaluated. The number of defined daily doses (DDD) per 100 patient days was calculated to compare glycopeptide use between four state university hospitals. At one of the hospitals with comparatively low glycopeptide usage but an active antimicrobial management program, data were prospectively evaluated for 1995 to 2000 to assess the variation of glycopeptide use over time. Results: The 3-year averages in glycopeptide use for the four hospitals ranged between 1.03 and 3.14 DDD/100 patient days. In all four hospitals, glycopeptide use was higher in the medical service (range, 1.59-7.26) than in the surgical service (range, 0.66-4.39). Active antimicrobial management in one of the hospitals was associated with containment of glycopeptide consumption in the medical and surgical service at < 1.5 DDD/100 patient days in the last 3 years. Conclusion: Glycopeptide use differs considerably at tertiary care hospitals in southern Germany, but use of < 1.5 DDD/100 patient days in both surgical as well as medical tertiary care hospital departments appears achievable.