Background: A 55 years old, Javanese man suffered diarrhea more than 8 times since 7 days before and complained a fever, feeling a pain and stiffness in the abdomen. His feces was watery, sometimes with mucus and blood. Previously he had suffered Diabetes Mellitus since 5 years ago and had been doing a regular treatment at local health facilities. Result: Random Blood Glucose test was 136 mg/dl, so the early diagnosis was a regulated DM and acute diarrhea caused by suspected Shigella infection. The initial treatment was intravenous Ciprofloxacin 400mg injection, but the patient’s condition did not get any improvement. After 5 days of treatment, the Feces culture showed ESBL producing E. coli and resistant to Ciprofloxacin but sensitive to Meropenem. So the drug choice of antibiotics was replaced into Meropenem. Six days later, the patient’s clinical and laboratory parameters were improved. The feces re-culture results showed there was no growth of E. coli. Then, the antibiotic was changed to Meropenem. Conclusions: The patient had succeeded according to standard procedures for ESBL and became better condition and had a good prognosis. Thus, the special treatment for patient who experience ESBL was a treatment which according to standard procedures and the selection of appropriate antibiotics.

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