Responsible antibiotic usage (ABU) is crucial for both animal and human health and requires constant improvement of antimicrobial stewardship (AMS). The presence of porcine reproductive and respiratory syndrome virus (PRRSV), a viral pathogen with immunosuppressive effects on swine, can intensify bacterial co-infections, alter antibiotic pharmacokinetics, and potentially lead to increased ABU. This study aimed to measure ABU changes in the grow-finish population associated with PRRSV infection and describe the antibiotic classes employed to manage clinical signs from a farrow-to-finish genetic multiplier system. Three PRRSV statuses (naïve, positive epidemic, and positive endemic) were established to classify the lots based on PRRSV circulation, with a total of 135,063 animals evaluated. The number of pig treatments per animal days at risk (PTDR) was calculated by administration route to quantify ABU across PRRSV status using negative binomial regression and non-parametric tests (P-value < 0.05). Moreover, to improve ABU comparability in the international scenario, the milligrams per population correction unit (mg/PCU) was calculated according to the European Medicines Agency guidelines. In the nursery phase, there was a statistically significant difference between PRRSV statuses for the overall PTDR (injectable and water routes of administration), with an ABU increase of 3.79 and 2.51 times the naïve PTDR for positive epidemic and endemic status, respectively. For the finishing phase, there was a statistically significant difference between PRRSV statuses in the injectable PTDR, with an ABU increase of 2.74 and 2.28 times the naïve PTDR level for positive epidemic and endemic statuses, respectively. In the nursery phase, the mean mg/PCU was 22.27 mg/PCU for naïve, 86.71 for positive epidemic, and 33.37 for positive endemic statuses; in the finishing phase, 81.31, 76.55, and 67.09 mg/PCU, respectively. The most frequently injected antibiotic in the nursery phase was ampicillin, with 49 % of total injections, followed by lincomycin (31 %) and enrofloxacin (20 %), and in the finishing phase, 72 % of injections were lincomycin, followed by enrofloxacin (28 %). The results highlight that the PRRSV outbreak in the source was associated with a grow-finish ABU increase, revealing the importance of preventing PRRSV infection to potentially decrease ABU and improve AMS within swine production systems.