This article reports a postcraniotomy patient with renal insufficiency and electrolyte imbalance who developed ventilator-associated pneumonia caused by extensively drug-resistant Klebsiella pneumoniae. According to the patient’s pathophysiological characteristics, bacterial epidemiological characteristics, and bacterial culture results, combined with the latest guidelines and the pharmacokinetic/pharmacodynamic characteristics of antibiotics, a full-dose ceftazidime/avibactam regimen was initially suggested by the clinical pharmacist, and which was adopted by doctor. When the effect of ceftazidime/avibactam was poor and no guideline-recommended alternatives were available, the clinical pharmacist, in conjunction with clinical experience, proposed a combination therapy of colistin sulfate and tigecycline, with the implementation of adverse reaction monitoring and mucin sulfate blood concentration monitoring. Finally, the pneumonia was effectively controlled, the inflammatory indicators such as temperature and the white blood cell count returned to normal, no adverse drug reactions occurred, and the patient was successfully transferred to the rehabilitation institution. Clinical pharmacists stay updated on the latest medication knowledge both domestically and internationally, recommend advanced drug treatment protocols for clinical practice, assist in managing severe infections, and play an important role in the clinical team.

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