Case Report: pharmaceutical care in a case of complicated urinary tract infection combined with disseminated Nocardia brasiliensis infection
By
Houjun Pang
Chuan Pi
Pengyu Shen
Ziru Tang
Erhao Bao
Xing Luo
Qixiong Zhang
June 11, 2026
Clinical Scorecard: Pharmaceutical Management in a Complex Case of Urinary Tract Infection Complicated by Disseminated Nocardia brasiliensis Infection
At a Glance
Category Detail
Condition Key Mechanisms Rapid pathogen diagnosis using metagenomic next-generation sequencing (mNGS) and dynamic pharmaceutical monitoring. Target Population Care Setting
Key Highlights
Initial empirical therapy with meropenem was ineffective, leading to regimen adjustment. Pathogen identification via mNGS guided targeted therapy with TMP-SMX and linezolid. Severe thrombocytopenia prompted a switch to amoxicillin/clavulanate potassium. Dynamic monitoring allowed for timely adjustments to treatment regimens. Guideline-Based Recommendations
Diagnosis
Utilize metagenomic next-generation sequencing (mNGS) for rapid pathogen identification. Management
Initiate empirical therapy based on clinical presentation and adjust according to pathogen identification. Monitoring & Follow-up
Implement proactive monitoring for adverse drug reactions and adjust treatment as necessary. Risks
Be aware of potential severe adverse reactions such as thrombocytopenia from certain antibiotics. Patient & Prescribing Data
Initial treatment with meropenem was ineffective; subsequent therapy with TMP-SMX and linezolid was adjusted due to adverse effects.
Clinical Best Practices
Employ rapid diagnostic tools for timely identification of pathogens. Adopt a dynamic approach to pharmaceutical care, allowing for treatment adjustments based on patient response. Monitor for adverse drug reactions closely, especially in patients receiving multiple antibiotics. Related Resources & Content
