OBJECTIVE To explore the role of clinical pharmacists in the treatment process of patients with glial fibrillary acidic protein(GFAP) astrocytopathy complicated by multidrug-resistant pulmonary infection.

METHODS Clinical pharmacist participated in the diagnosis and treatment process of a patient with GFAP astrocytopathy and multidrug-resistant pulmonary infection. The pharmacist monitored the patient who experienced acute upper gastrointestinal bleeding during steroid therapy, suggested discontinuing methylprednisolone, and recommended pantoprazole sodium 40 mg, bid, intravenously infused for hemostasis treatment. Based on the patient's pulmonary infection symptoms and signs, etiological results, and the pharmacokinetic characteristics of the antibiotics used, it was suggested to change imipenem-cilastatin to polymyxin B sulfate(initial dose 1 million units, maintenance 500 000 units), q12h combined with tigecycline(initial dose 200 mg, maintenance 100 mg), q12h. Due to poor infection control, it was suggested to discontinue polymyxin B and tigecycline, and change to fosfomycin sodium 4 g, q8h combined with meropenem 2 g, q8h infused over 3 hours. The adverse reactions of patients with skin pigmentation during the use of polymyxin B were identified and analyzed.

RESULTS The clinical physician accepted the recommendations of the clinical pharmacist. After treatment, the patient improved and was discharged.

CONCLUSION The clinical pharmacist, through participation in the pharmaceutical care of a patient with GFAP astrocytopathy and multidrug-resistant pulmonary infection, assisted the physician in optimizing the treatment plan, ensuring the efficacy and safety of the patient's medication use.