[Solved]: A 55 yo is admitted into the hospital in septic shock

A 55 yo is admitted into the hospital in septic shock. Renal function has diminished with a BUN/Scr currently at 45/2.5. Vancomycin has been initiated and patient has received 1 gram x1 dose at 0800 today. CVVHD is about to be initiated now at 1600 and patient’s initial Blood cx’s are now showing gram positive cocci in clusters. The provider wants to know what the next steps should be to manage this patient’s therapy. What would you do and why?