Presence of ANY ONE of the following risk factors for MDR Gram-negative pathogens or poor outcomes:
- Requiring ICU care: septic shock and/or mechanic intubation
- In ICU when symptoms appear, or transferred from ICU in the last 48 hours
- Prior intravenous antibiotic use within 90 days
- Immunosuppression
- Structural lung disease (e.g., bronchiectasis, cystic fibrosis)
- Colonization or recent prior infection with Pseudomonas or other resistant Gram-negative bacilli (e.g., ESBL or AmpC)