This article retrospectively analyzed the involvement of clinical pharmacists in the treatment process and implementation of pharmacological supervision in a patient with septic arthritis secondary to tophi ulceration. The patient was admitted to the hospital and the emergency debridement and tophi removal were performed. Piperacillin-tazobactam, imipenem cilastatin, levofloxacin, linezolid, and vancomycin were given successively, and multiple debridement and drainage were performed, but the patient remained febrile and had recurrent infection indicators. According to the relevant guidelines and evidence-based evidence, combined with the patient's infection indicators, pathogen results and creatinine clearance rate, the clinical pharmacists recommended stopping vancomycin and changing to cefazolin, and the clinicians adopted it. After that, the patient's inflammatory indicators gradually decreased, and the body temperature stabilized. After 28 days of piperacillin-tazobactam administration, the patient developed a reduction in white blood cell count (2.34×10⁹·L^-1) and potassium (2.98 mmol·L^-1). The pharmacist recommended prompt discontinuation of the drug, and the patient's white blood cell count and potassium gradually recovered. Eventually, after anti-infective treatment and surgical intervention, the patient was discharged with closure of the infected foci, conversion of multiple blood cultures to negative, and stabilisation of body temperature and renal function. This case reflects the role of clinical pharmacists in the management of drug treatment of critically ill patients, and may provide practical experience and reference for clinical treatment of such cases.

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