Introduction: This study aimed to determine the resistance patterns of Escherichia coli (E. coli) in Mexico to several antibiotics and research some therapeutic options. Methodology: Positive cultures for E. coli isolated from bronchial secretions, urine, central catheter, blood, and infected wounds in the Culiacan General Hospital, Sinaloa, Mexico from 30 June 2004 to 1 July 2007 were studied. Resistance against multiple antibiotics was measured and compared by gender and the hospital unit where the bacteria were isolated. Results: In total, 1511 specimens were analyzed from men (45.4%) and women (54.5%), of which 251 were positive for E. coli. Antimicrobial resistance was highest in the neurosurgery service (58.4%). Samples included sputum (14.7%), bronchial secretions (17.9%), wounds (35.4%), urine/Foley catheter tip (35.5%), central catheter tips (5.6%), and blood cultures (7.2%). Resistance to ampicillin was highest at 91% followed by ciprofloxacin at 80.6%, trimethoprim-sulfamethoxazole at 70.2%, piperacillin/tazobactam at 14.4%, and imipenem at 6.8%. Conclusions: Trimethoprim should not be recommended as an empiric option for E. coli infections and the benefit of quinolones is low. It is important to understand the resistance of the bacteria in each medical center, consider its frequency in each service within the same hospital, and take all necessary measures to ensure and create a clinical attitude of prevention.