A 44-year-old man presents to the emergency department with 2 days of an abruptly swollen, hot and painful right knee, fever and inability to bear weight. He has type 2 diabetes treated with metformin and injects hydromorphone intravenously most days. He has no known drug allergies. On examination, the right knee has a large warm effusion and severe pain with any passive movement. Laboratory results show WBC 17.5 x 10^9/L (4.0-11.0), CRP 210 mg/L (less than 8), glucose 14.2 mmol/L and eGFR 85 mL/min/1.73 m2 (greater than 60). Arthrocentesis yields turbid fluid with a synovial WBC of 78,000/mm3 (94% neutrophils); Gram stain is pending, and synovial fluid and blood cultures have been sent.
| Heart rate | 108/min |
| Respiratory rate | 20/min |
| Temperature | 38.9 °C |
| O2 saturation | 97%, room air |
| Blood pressure | 118/72 mm Hg |
Question 1 of 3
Cultures have been collected and the Gram stain is still pending. Which of the following are the most appropriate empiric antibiotics to start now?
Select 2. (0 / 2 selected)
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