Review Question - QID 214971

A 48-year-old man presents to the emergency room due to 1 week of fever, malaise, abdominal pain, and bloody stools. He has not had nausea, vomiting, or genitourinary symptoms. He has a history of cirrhosis secondary to hepatitis C from intravenous drug use. He underwent a deceased donor liver transplant 4 months ago and takes tacrolimus, prednisone, and mycophenolate. He previously smoked 1 pack of cigarettes per day for 20 years but quit 4 years ago. He does not currently drink alcohol. He has never traveled outside of the country. His temperature is 102.0°F (38.9°C), blood pressure is 140/60 mmHg, pulse is 97/min, and respirations are 13/min. His physical exam is remarkable for diffuse tenderness to palpation of the abdomen. Rectal examination reveals brown stool which is guaiac positive. Laboratory results are as follows:

Aspartate aminotransferase (AST): 110 U/L
Alanine aminotransferase (ALT): 168 U/L
Creatinine: 1.4 mg/dL
Human immunodeficiency virus (HIV)-1 antibody: Negative

A subsequent colonoscopy reveals linear ulcers throughout the colon. Which of the following is the most appropriate pharmacotherapy for the patient’s symptoms?