Influenza Quiz: Ace Your Exams

A 72-year-old woman presents to the emergency department with five days of cough and 2 days of shortness of breath. Five days ago the patient developed myalgias, a headache, nasal congestion, and a low-grade fever which had resolved, but the shortness of breath and cough have worsened. Past medical history is significant for type 2 diabetes mellitus. Current medications include empagliflozin and metformin. Temperature is 39.2 ºC (102.6 ºF), pulse is 90/min, respirations are 20/min, and blood pressure is 110/71 mmHg. Oxygen saturation is 92% on room air. On physical examination, the patient is tachypneic but is not using accessory muscles of respiration. On auscultation, there are rhonchi and decreased breath sounds at the left lung base. Nasal swab is positive for influenza A virus. Serum white blood cell count is 18,000 cells/mm³ (reference range: 4,500-11,000 cells/mm³) and procalcitonin is 1.3 ng/mL (reference range: <0.1 ng/mL). Which of the following medication combinations is most appropriate at this time?