This article presents the treatment approach for an elderly patient with acute exacerbation of chronic renal insufficiency complicated by severe infection. Based on the pathophysiological characteristics of infection in elderly patients with chronic renal insufficiency and in combination with relevant guidelines, the initial treatment regimen of meropenem combined with teicoplanin was adopted. As the patient's condition worsened, Staphylococcus aureus and Pneumocystis jirovecii were detected in the metagenomic next-generation sequencing of the bronchoalveolar lavage fluid. The combined treatment regimen of sulfamethoxazole-trimethoprim and caspofungin was then added to treat Pneumocystis jirovecii pneumonia. Additionally, clinical pharmacists provided pharmaceutical care, including monitoring for adverse reactions and therapeutic drug monitoring of teicoplanin. The patient's infection was ultimately controlled and discharged smoothly. Clinical pharmacists assisted clinicians in formulating a reasonable anti-infection treatment plans and implement pharmaceutical care to ensure the effectiveness and safety of clinical drug treatment.

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