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The 2024 Infectious Diseases Society of America (IDSA) guidance on the treatment of antimicrobial-resistant Gram-negative infections represents an effort to provide practice suggestions in the light of limited but rapidly evolving literature.1 Many of the suggestions stem from low-quality evidence or expert opinion extrapolated from non-clinical, in vitro data. One suggestion warranting further examination is the universal adoption of high-dose meropenem (ie, 2 g intravenously (IV) every 8 hours) as an extended infusion (EI) over 3 hours for all infections other than uncomplicated cystitis. While the guidance body text acknowledges patient-specific considerations, summary tables are frequently extracted and used in isolation, shaping institutional protocols and antimicrobial stewardship policies without the accompanying nuance. This illustrates a recurring theme and important flaw in the creation of guideline, guidance and other best practice documents: the absence of an agreed upon standard of evidence that should be met prior to making sweeping, practice-changing suggestions or recommendations.