Most antibiotics are only partially metabolised by patients before being discharged into the municipal sewage system along with patient excreta. Studies have shown that the majority of antibiotics pass through sewage treatment and are then released into the environment. Accordingly, investigations conducted in various countries have detected a number of antibiotics in the low μg or ng per litre range in different environmental compartments. Studies connecting mass balances of use on a local scale and of input and analysis of the antibiotic concentrations present in municipal sewage treatment plants are scarce. Data on local use of antibiotics and their relation to nationwide consumption are not available. This study investigated the use, input, and fate of antibiotics on a local scale and this data were compared with the German nationwide consumption. 42 antibiotics and 15 antimycotics were used in the mass balance consideration over a period of one year. It was found that the local pattern of usage differed only little from that found nationwide. Seasonal changes were minor and the concentrations actually measured were found to be in the expected range. Differences in both the identified occurrence and the concentrations of the target compounds were observed within and between the three sampling periods. © 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.