MRCP2-0738

MRCP2-0738

A 67-year-old man presents to the emergency department with dysuria and abdominal pain. He has a past medical history of chronic kidney disease stage IV. His medications include atorvastatin, amlodipine and ramipril.

On examination, there is mild suprapubic tenderness.

Urinalysis:

Nitrites positive
Leucocytes +++
Blood +
Protein +
Glucose negative

Blood tests:

Hb 137 g/L Male: (135-180)
Female: (115 – 160)
Platelets 189 * 109/L (150 – 400)
WBC 8.2 * 109/L (4.0 – 11.0)
Na+ 137 mmol/L (135 – 145)
K+ 4.2 mmol/L (3.5 – 5.0)
Urea 22.1 mmol/L (2.0 – 7.0)
Creatinine 278 µmol/L (55 – 120)
EGFR 23 mL/min/1.73m2 (90-120)
CRP 48 mg/L (< 5) Which antibiotic would be inappropriate for this likely diagnosis?