In recent years, the medical community has been grappling with a pressing issue: the rise ofantibiotic resistance in pathogenic microorganisms. This trend has made treating infectiousdiseases increasingly challenging, as the efficacy of many antibiotics has been compromised.This retrospective study examined 10,149 urine samples collected from Romanian patientsresiding in the northern mountainous area of the Eastern Carpathians in 2021-2022.Pathogenic bacteria were identified in 2420 (23.84%) urine cultures. Escherichia coli waspreponderant (74.20±2.35%), followed by Klebsiella sp. and Enterococcus sp (7.50±2.25% and6.55±3.20%), Proteus sp, Pseudomonas aeruginosa and Staphylococcus aureus (2.42%, 2.18%,and 2.06%). The susceptibility of E. coli to antibiotics decreases in the order: Nitrofurantoin,Aminoglycosides (Gentamicin and Amikacin) and Cephalosporins gen III (Cefotaxime,Ceftriaxone), Fluoroquinolones (Ciprofloxacin and Levofloxacin), Fosfomycin, Amoxicillin&Clavulanic acid, Ampicillin, and Amoxicillin. Klebsiella sp. are significantly sensitive toAminoglycosides, Amoxicillin&Clavulanic acid, Cephalosporins, and Fluoroquinolones.Enterococcus sp has a remarkable susceptibility to Ampicillin, Amoxicillin, and Nitrofurantoin;Proteus sp to Amoxicillin&Clavulanic acid and Cephalosporins and P. aeruginosa toPiperacillin&Tazobactam, Amikacin, Ceftazidime, and Imipenem. S. aureus was identified in afew urine bacterial cultures, so the study was performed on methicillin-sensitive (MSSA) andmethicillin-resistant (MRSA) strains.Our study's findings have significant applications in UTI treatment strategy. E. coli, the mostfrequent pathogen of urinary tract infections, can be effectively targeted with Fluoroquinolonesas the primary antibiotic therapy choice. This is particularly reassuring given the resistancelevels of E. coli to Fluoroquinolones, significantly below the national average of approximately29.1%. The second line-antibiotics, including Aminoglycosides (Gentamicin, Amikacin), Betalactams (Amoxicillin&Clavulanic acid, Cephalosporins), and Nitrofurantoin, also revealed highinhibitory potential against E. coli and could be considered effective treatment options inurinary tract infections caused by this Gram-negative pathogen, offering hope for effectivetreatment strategies.