This article reports the treatment process and key points of pharmaceutical care for a patient with acute suppurative cholecystitis complicated by septic shock and multiple organ dysfunction. The patient was admitted due to acute suppurative cholecystitis in critical condition, subsequently developing septic shock and multiple organ injuries involving the liver, kidneys, and heart. Initial anti-infective therapy was initiated with meropenem 1 g, q12h. After evaluation, the clinical pharmacist determined that the increased volume of distribution in the early stage of septic shock made it difficult to achieve rapid target concentrations with conventional dosing, and therefore recommended administering a loading dose in the first administration, with subsequent adjustments based on dynamic changes in renal function. Postoperatively, the patient developed acute kidney injury, and the pharmacist recommended adjusting meropenem to 0.5 g, q8h with extended infusion over 3 h to balance renal injury management and anti-infective efficacy. Later, as renal function recovered, meropenem was readjusted to the conventional regimen of 1 g, q12h. In response to dynamically elevated pro-BNP levels, the pharmacist assessed that volume overload and hypokalemia were the primary contributing factors, and recommended implementing refined volume management and actively correcting hypokalemia to create favorable conditions for cardiac function recovery. Following these interventions, the patient's infection was controlled and organ functions recovered. This case demonstrates that clinical pharmacists, by applying PK/PD principles and dynamically adapting to the patient's changing condition, can implement individualized pharmaceutical care and play a valuable role in optimizing treatment regimens for severe infections and preventing adverse reactions.

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