摘要对1例医院获得性肺炎合并严重肾功能不全需要血液透析的在使用头孢吡肟和左氧氟沙星抗感染后发生精神系统症状的老年患者进行分析，探讨不良反应发生的原因并总结经验。对于肾功能不全需要血液透析的老年患者，使用经肾脏排泄的药物应根据肌酐清除率调整给药剂量或延长给药间隔，否则按常规剂量给药，易导致药物积蓄，发生精神系统不良反应。临床药师利用自身专业知识对肾功能不全及其合并症患者的药物进行药学分析与监护研究，可以更好地保障临床治疗。

abstractsAnalysis was made on an elderly patient with hospital-acquired pneumonia and severe renal insufficiency who required hemodialysis and who had nervous system symptoms after the use of cefepime and levofloxacin against infection. The causes of adverse reactions were explored. The experience was summarized. For elderly patients with renal insufficiency who require hemodialysis, the dosages of the drugs excreted through kidney should be adjusted according to creatinine clearance rate, or the administration interval should be extended, otherwise even conventional dosage may lead to nervous system adverse reactions induced by the accumulation of drugs. Clinical pharmacists engage with their own expertise in pharmaceutical analysis and monitoring research for renal insufficiency patients and ensure clinical care better.