Non-severe: Withhold broadened coverage and expand if isolated by culture
Severe (septic shock with need for vasopressors or mechanical ventilation): Expand coverage for MRSA/P. aeruginosa
Expand coverage to pathogen previously isolated
Associated w/ higher risk of C. difficile
WITH or WITHOUT
PLUS
PLUS
OR
Switch to oral/enteral therapy as soon as patient is clinically improving and able to tolerate oral medications