To introduce a strategy for a case of severe pneumonia complicated with lung abscess caused by Fusobacterium necrotum. The pathogen was not identified, but the patient was still coughing up feverish bloody sputum after being treated with meropenem, linezolid and ornidazole. The results of detection of pathogen metagenomes in bronchoalveolar lavage fluid by posterior bronchoscopy suggested that the pathogen was Fusobacterium necrophorum, according to the characteristics of bacteria, the dynamic changes of clinical symptoms, liver and kidney function, body temperature and blood picture infection index,combined with the results of bacterial culture/drug sensitivity test, bronchoalveolar lavage fluid NGS and the pharmacokinetic/pharmacodynamic characteristics of antimicrobial agents, to propose an anti-infective regimen that is strategically adjusted to imipenem cilastatin (1.0 g, ivd, q8h) plus ornidazole (0.5 g, ivd, q12h) for the implementation of pharmaceutical care after adoption by physicians. After 21 days, the patient's severe infection and lung abscess was controlled and patient was discharged. In this case, clinical pharmacists study the bacterial characteristics of Fusobacterium necrotum, review a large number of domestic and foreign literature to track the frontier knowledge of antimicrobial agents, and use their own expertise to provide effective pharmaceutical support for the clinical team, to assist clinical team in the diagnosis and treatment of rare infections, to achieve professional value.

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