The problem of carbapenem-resistant gram-negative flora in intensive care units (ICUs) is a major challenge for modern critical care. Limitations and toxicity of modern therapeutic options create significant difficulties in management of critically ill patients. A promising alternative is a new domestic drug fluorothiazinon with unique mechanism of action aimed at suppressing virulence of microorganisms rather than their direct eradication. The authors present successful treatment of a patient with postoperative pneumonia, mediastinitis, pleural empyema, and septic shock caused by a strain of Klebsiella pneumoniae with the blaOXA-48-like gene. Therapy with meropenem (in high dose with extended infusion) and fluorothiazinon was followed by positive dynamics with hemodynamic stabilization, regression of organ dysfunction, and improvement of laboratory markers. The authors concluded high clinical efficacy and favorable safety of fluorothiazinon combined with carbapenem for the treatment of infections caused by carbapenem-resistant gram-negative flora. Potential niches for this drug are total or subtotal drug resistance, as well as the need for long-term suppressive therapy for chronic recurrent infections.