<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 48-year-old female with a history of hypertension, type II diabetes mellitus, hypothyroidism, and asthma undergoes a scheduled total abdominal hysterectomy for symptomatic fibroids. She is given a dose of preoperative prophylactic antibiotics. Her urinary catheter is removed on post-operative day one. She is on low-molecular-weight heparin for deep vein thrombosis prophylaxis. On post-operative day four, the patient complains of abdominal pain. She denies cough, nausea, vomiting, or dysuria, but has had 3-4 loose stools over her hospitalization. Her temperature is 101.0F 38.3C, blood pressure is 9759 mmHg, pulse is 106min, and respirations are 16min. The surgical wound has new erythema with dusky patches and abundant cloudy discharge. The patient reports new decreased sensation around her wound site. Her lungs are clear to auscultation and abdomen is soft with hypoactive bowel sounds. She has no costovertebral angle tenderness. Urinalysis is within normal limits and urine culture grows 100,000 CFUmL of Escherichia coli.Which of the following is the best next step in management?? A: Discontinue low-molecular-weight heparin, B: Oral levofloxacin for 3 days, C: Oral vancomycin for 10-14 days, D: Vancomycinpiperacillin-tazobactamclindamycin and observation, E: Vancomycinpiperacillin-tazobactamclindamycin and debridement of the surgical wound,  <response>: This is a question about the management of a postoperative patient with signs and symptoms of surgical site infection. The key findings in the stem are:- 48 year old female with multiple comorbidities - Underwent total abdominal hysterectomy - Received preoperative antibiotics- On postoperative day 4 has fever, tachycardia, wound erythemadischarge, decreased sensation around wound, positive urine culture- Most consistent with surgical site infectionThe choices include discontinuing heparin, oral antibiotics for UTI, IV antibiotics alone or with debridement. The patient has signs of surgical site infection so oral antibiotics for UTI alone are not sufficient. Heparin is for DVT prophylaxis which is still needed. IV antibiotics covering common surgical site pathogens are appropriate. Given the local wound findings, debridement is also indicated.E: Vancomycinpiperacillin-tazobactamclindamycin and debridement of the surgical wound 