Soru

A 64-year-old man comes to the urgent care clinic due to the sudden onset of severe pain, swelling, and redness in his left knee that awoke him from sleep. He has a history of ischemic cardiomyopathy with a left ventricular ejection fraction of $30\%$, chronic kidney disease with a baseline serum creatinine of $2.7 \text{ mg/dL}$, and a recent diagnosis of atypical community-acquired pneumonia for which he began taking clarithromycin $3$ days ago. His temperature is $37.2^{\circ}\text{C}$ ($99.0^{\circ}\text{F}$), blood pressure is $118/76 \text{ mm Hg}$, and pulse is $82/\text{min}$. Physical examination shows a warm, erythematous, and exquisitely tender left knee with a moderate effusion. Arthrocentesis is performed, yielding synovial fluid with a leukocyte count of $35,000/\mu\text{L}$ ($90\%$ neutrophils). Polarized light microscopy reveals needle-shaped, negatively birefringent crystals. Gram stain shows no organisms. Which of the following is the most appropriate pharmacologic intervention for this patient's current joint condition?