Background: Antimicrobial resistance is a major public health threat, with extended-spectrum β-lactamase (ESBL)-producing bacteria from the Enterobacteriaceae family classified by the WHO as critical priority pathogens. The COVID-19 pandemic affected global antibiotic consumption patterns, potentially influencing the resistance of ESBL(+) strains and the frequency of bacterial infections in hospitals. Objective: This study aimed to analyze the trends in the prevalence of infections caused by ESBL-producing bacteria (Enterobacteriaceae family) in a district hospital in the Lower Silesian Voivodeship during the peri-pandemic period (2017–2023) and assess the relationship between antibiotic consumption and changes in resistance. Material and methods: A retrospective cohort study was conducted using microbiological and pharmacological data from the Healthcare Complex in Oława. 34,629 clinical specimen cultures from 77,829 hospitalized patients were analyzed. The study focused on Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp. with an ESBL resistance mechanism. The consumption of β-lactam antibiotics from Anatomical Therapeutic Chemical (ATC) Classification System groups J01C and J01D was assessed. Statistical trend and correlation analysis was applied. Results: The incidence of ESBL(+) bacterial infections showed no significant trends. The pre-pandemic prevalence of ESBL(+) strains was low (6.42%–24.49%), rising to 56.25% in 2020 and peaking at 100% in 2021–2022. In 2023, resistant isolates declined to 77.50%. A 50.2% increase in β-lactam antibiotic consumption (J01D, mainly cephalosporins) was recorded in 2020. The highest proportion of ESBL(+) infections occurred in non-surgical wards (40.97%) and long-term care facilities (25.88%). Conclusions: Data analysis from 2017–2023 revealed no significant trends in incidence of ESBL(+) infections but an increase in β-lactam resistance. In 2020, the prevalence of ESBL(+) strains and antibiotic consumption, especially cephalosporins, increased. However, the lack of a significant correlation between antibiotic consumption and resistance suggests that other factors, such as resistant strain transmission or persistent colonization, play a crucial role. These findings highlight the need for enhanced resistance monitoring and rational antibiotic stewardship strategies.