I have stayed countless times at Posada Refugio because it's cheap and convenient. However, it's not exactly clean at all times and I have seen cockroaches on the walls. There are other places in Antigua with better accomodations for a good price (see the Burkhart).
I wouldn't recommend staying at the Refugio unless you are looking for a really cheap place. Hot water is hit and miss, bedbugs are known to plague people (although I have never had them) and the magagement is curt. If you want to stay out later than 1AM, you have to arrange with someone at the desk and usually have to pay him off with at least 300Q.
If you have a choice, go someplace else.
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