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A 68-year-old woman (60 kg, 160 cm) is discharged with a new prescription for levofloxacin 750 mg by mouth daily for 7 days for pneumonia. Current medications: metformin 500 mg twice daily and lisinopril 10 mg daily. Labs: serum creatinine 2.1 mg/dL (reference 0.6–1.3), estimated creatinine clearance 22 mL/min, alanine aminotransferase 18 U/L (reference 7–56). Allergy: none known. The prescription was entered and verified without renal dose adjustment. What is the most critical error in this scenario?
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