Taking an antibiotic “just in case” a cold gets worse does not prevent viral complications. Instead, it can cause adverse effects and encourage the selection of resistant bacteria. In Romania, the latest available European data for 2024 point to a worrying rise in certain invasive infections caused by resistant bacteria, including carbapenem-resistant Klebsiella pneumoniae—bacteria usually used in severe situations.
The term “superbugs” is memorable, but it can be misleading. There is no mysterious species that suddenly emerges from a pill. These are ordinary bacteria that have accumulated mechanisms helping them survive one or more antibiotics. Sometimes they can be treated with other medicines; at other times, the options become far fewer, more toxic, more expensive or more difficult to administer.
What the latest data for Romania show—and what they do not
The ECDC report published on 18 November 2025, based on 2024 data, estimates 20.31 bloodstream infections per 100,000 inhabitants in Romania involving carbapenem-resistant Klebsiella pneumoniae. In 2019, the estimate was 7.12 per 100,000. The calculated increase over 2019–2024 is 185.3%.
To complement the information above, you can also read Heatwave in Romania: What to Do to Avoid Ending Up in Hospital. Temperatures of Up to 41°C in the Coming Period, an article that explores an aspect directly related to this subject.
The same dataset indicates 9.68 invasive infections involving third-generation cephalosporin-resistant Escherichia coli per 100,000 inhabitants in Romania, compared with 6.32 in 2019. For MRSA—meticillin-resistant Staphylococcus aureus—the estimate for 2024 is 13.15 per 100,000 inhabitants. These figures do not describe all colds, urinary tract infections or prescriptions issued in the community. They refer to isolates from blood and, in a very small proportion, cerebrospinal fluid: in other words, serious, invasive infections.
There is also an essential limitation: the ECDC flags Romania’s data with caution. For 2024, the estimated population coverage in the reporting system was 15%, while geographical, hospital and isolate representativeness was assessed as low. The figures are therefore a strong epidemiological signal, not a perfect measurement of the national burden. That very limitation shows why laboratory surveillance and proper specimen collection matter as much as the message directed at patients.
| ECDC indicator for Romania | 2019 | 2024 | 2030 target |
|---|---|---|---|
| Total antibiotic consumption in humans (defined daily doses/1,000 inhabitants/day; 2023 data in the country profile) | 25.8 | 27.4 in 2023 | 18.8 |
| Invasive infections involving third-generation cephalosporin-resistant E. coli, per 100,000 inhabitants | 6.32 | 9.68 | 6.0 |
| Invasive infections involving carbapenem-resistant K. pneumoniae, per 100,000 inhabitants | 7.12 | 20.31 | 6.76 |
Consumption data for 2023, published by the ECDC in Romania’s country profile, also show the direction of the problem: total consumption was higher than the 2019 baseline, although the European objective is to reduce it by 2030. Not all use is unnecessary—antibiotics save lives when they are properly indicated—but high consumption and frequent use of broad-spectrum antibiotics increase selection pressure on bacteria.
It is not the patient who becomes resistant. Bacteria do
A common phrase is “I have become used to the antibiotic” or “my body no longer responds.” Biologically, the issue is different: within a bacterial population, some bacteria may be less sensitive to the medicine. The antibiotic kills susceptible bacteria, while those with defence mechanisms may remain and multiply. Some bacteria can pass resistance genes to one another.
That is why an incorrectly chosen dose, failure to follow dosing intervals, starting treatment without a diagnosis or using leftovers from a previous illness are not neutral actions. They may expose bacteria to an unsuitable medicine or inadequate concentrations. In addition, the patient loses time before receiving the correct treatment.
Antimicrobial resistance does not concern antibiotics and bacteria alone: the broader term also includes resistance to antivirals, antifungals and antiparasitic medicines. In daily life, however, the most common confusion is between antibiotics and treatment for a viral infection. Antibiotics act on certain bacteria, not on the viruses that cause colds, flu or most seasonal respiratory infections.
Why the stakes go beyond a family cold
A resistant bacterium can cause urinary tract infections, pneumonia, and infections of the skin, wounds or bloodstream. Risk and severity vary greatly from person to person: advanced age, weakened immunity, hospitalisation, invasive procedures and medical devices such as catheters can be decisive factors.
In hospitals, resistance can make healthcare-associated infections harder to treat. Outside hospital, the same problem becomes apparent when a seemingly ordinary infection does not respond to the first option, or when the doctor must choose treatment based on a urine culture, swab, blood culture or susceptibility test. An antibiotic susceptibility test is the laboratory test that shows which antibiotics the isolated bacterium is susceptible or resistant to.
Not every sore throat needs to be investigated through complex tests. The decision depends on symptoms, clinical examination, age, coexisting conditions and severity. The important point is that an antibiotic should not replace a diagnosis. When a doctor recommends monitoring, symptom treatment or a follow-up visit instead of an immediate prescription, this may be a responsible medical decision, not an absence of treatment.
Four common situations: what is wrong and what helps
| Situation | Why it may be a problem | Helpful step |
|---|---|---|
| “I have a cold, so I’ll take an antibiotic to stop it going to my chest.” | Colds and flu are caused by viruses; antibiotics do not shorten them or automatically prevent complications. | Discuss symptoms and warning signs with your doctor. Follow the plan you have been given for fever, hydration and monitoring in your particular case. |
| “I have a few capsules left from last time.” | The current illness may have a different cause, and the remaining amount does not constitute a treatment regimen. | Do not use them or give them to someone else. Ask a pharmacist how they can be disposed of safely. |
| “I feel better, so I’ll stop treatment.” | The regimen may need reassessment, but stopping it unilaterally may leave the infection insufficiently treated. | Take the medicine exactly as prescribed; if adverse effects or questions arise, call your doctor or pharmacist before changing the treatment. |
| “My antibiotic helped my child/spouse too.” | The dose, contraindications, allergies and even the cause of illness may be entirely different. | Do not share antibiotics. A person who needs treatment must be assessed individually. |
What to do if a doctor prescribes an antibiotic
Responsible use does not mean automatically refusing an antibiotic. In a bacterial infection for which it is indicated, delay or incorrect administration can be dangerous. The goal is the right treatment, for the right person, for the right duration.
- Ask what infection is suspected or confirmed. An answer may sometimes be probabilistic, especially at the outset; the doctor may recommend reassessment or tests if the course is not as expected.
- Check the regimen before leaving the pharmacy. The name, dose, number of doses per day, relationship to meals and duration should be clear. If you do not understand the instructions, ask for clarification.
- Do not adjust the dose and schedule yourself. A missed dose, vomiting after administration or combining it with other medicines are situations in which the advice depends on the product and the timing. A pharmacist or doctor can tell you what is safe to do.
- Do not keep leftovers for another illness. A leftover is not “backup treatment,” but a risk of self-medication and delayed correct diagnosis.
- Report adverse effects promptly. Severe or persistent diarrhoea, a widespread rash, swelling of the face, difficulty breathing, feeling faint or worsening general condition require prompt medical assessment. In the event of difficulty breathing, loss of consciousness, confusion or other emergency signs, call 112.
For guidance in the event of a sudden deterioration, the pointers in InfoBuz’s article on situations in which 112 should be called may also be useful. However, they do not replace the instructions received for the current illness.
In Romania, antibiotics are dispensed by prescription, with a limited exception
Ministry of Health Order No. 63/2024, in its consolidated form following amendments published in 2025, regulates the monitoring of the prescribing and dispensing of systemic antibiotics and antifungals. The rule is dispensing on the basis of a medical prescription.
There is an exception for exceptional emergency situations: certain products marked in the annex may be dispensed without a prescription only in a quantity not exceeding a 48-hour dose, only once during a course of treatment and on the basis of the declaration provided for by the order. This provision does not turn the pharmacy into a place for self-medication for viral infections, nor does it mean that an antibiotic may be started “just in case.”
The regulation also has a public-health purpose: pharmacies report daily transactions involving these medicines, and the information can help authorities monitor their use. Administrative rules alone do not solve bacterial resistance, but they reduce the scope for repeated, unjustified purchases.
Why it is not enough to blame patients
Unnecessary antibiotic use by individuals is a real part of the problem, but it is not the entire explanation. Resistance is also influenced by prescribing in outpatient settings and hospitals, the availability of microbiological tests, infection prevention and control, hand hygiene, vaccination, antimicrobial use in animals and environmental protection. This is the “One Health” approach: human, animal and environmental health are interconnected.
Likewise, the message “do not take antibiotics” must be applied correctly. It does not concern patients alone, but also the system: access to consultations, tests and reassessment must be possible; otherwise, people are pushed towards quick but risky solutions. An informed patient can ask the right questions; they cannot and should not determine their own diagnosis or regimen.
A simple check before the first pill
Before taking an antibiotic you have at home, pause and ask three questions: was it prescribed for me and for the current episode? Do I know exactly how to take it? Do I have a plan if my condition worsens or adverse effects occur? If the answer to any of these is “no,” the next step is not a capsule, but a doctor or pharmacist.
The signal in Romania’s data does not call for panic or justify avoiding necessary treatment. It calls for greater precision. The right antibiotic, taken at the right time, can save lives. An antibiotic taken without reason or according to an invented regimen can make the next serious infection—our own or someone else’s—harder to treat.
Frequently asked questions
Do antibiotics treat flu or colds?
No. Colds and flu are viral infections, and antibiotics act on certain bacteria. A doctor may assess whether signs suggesting another infection or a complication have appeared, but antibiotics are not routine treatment for viral infections.
Can I take an antibiotic left over from an old treatment?
No. Leftovers may be unsuitable for the current illness, the remaining dose may be insufficient, and taking them may delay correct diagnosis and treatment. Antibiotics should not be shared among family members.
What does an antibiotic-resistant bacterium mean?
It means that the bacterium has mechanisms that help it survive one or more antibiotics. It is not the person who becomes resistant, although they may have an infection or carry a resistant bacterium.
Should I stop the antibiotic if I develop diarrhoea or a rash?
Do not change the regimen yourself without seeking advice from a doctor or pharmacist. Mild and severe reactions are managed differently. Difficulty breathing, swelling of the face or throat, fainting and a severely impaired general condition require urgent medical help.
Can antibiotics be dispensed without a prescription in Romania?
The rule is dispensing on the basis of a medical prescription. The order in force provides a strict exception, for certain medicines and for a maximum of 48 hours, in exceptional emergency situations; this is not permission for self-medication.
