IDSA guidelines do not support longer courses of antibiotics, even for (previously recommended) non-glucose-fermenting gram-negative bacilli.
*MRSA risk factors:
**For any toxic patient, consider a Vancomycin loading dose of 25 mg/kg followed by 15 mg/kg every 12 hours. Every Vancomycin order requires pharmacokinetic consult.
Transition to oral: When hemodynamically stable and clinically improving.