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This case report describes an elderly patient who underwent kidney transplantation and was receiving long-term immunosuppressive therapy. The patient was admitted with persistent fever and pneumonia, and empirical antimicrobial therapy with trimethoprim-sulfamethoxazole (TMP-SMZ) (1 440 mg q8 h, oral) was initially administered. Considering the patient’s renal function and immunosuppressive status, the clinical pharmacist adjusted the dosage of TMP-SMZ to 960 mg q8 h based on the population pharmacokinetic (PopPK) model. Therapeutic drug monitoring (TDM) was performed to closely monitor the peak drug concentrations, with results showing SMZ at 134 μg·mL-1 and TMP at 4.84 μg·mL-1, which were consistent with the concentrations predicted by the PopPK model and fell within the therapeutic window. This validated the scientific rationale and appropriateness of the adjusted dose. In coordination with the adjusted immunosuppressive regimen, the patient’s condition gradually improved, leading to eventual discharge in stable condition. Through this case, the clinical pharmacist provided comprehensive individualized pharmaceutical care, ensuring the rationality, effectiveness and safety of treatment through precise drug dosage regulation and dynamic monitoring during the treatment process. This case also contributed to the standardization and rationalization of clinical medication for post-kidney transplant Pneumocystis jirovecii pneumonia (PJP) patients while enhancing the pharmacist’s professional skills and value.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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