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the 1970s because of significant renal and neurological toxicity. [ 4 ] At present, COL is increasingly put forward as salvage or first-line treatment for severe MDR-GNB infections, particularly in the ICU. [ 5 ] COL is administered intravenously as the inactive prodrug colistimethate sodium (CMS) that is hydrolyzed to COL. From a pharmacodynamic/pharmacokinetic (PK/PD) viewpoint, COL possesses rapid concentration-dependent bacterial killing against susceptible strains, but the ratio of the area under the concentration time curve of the unbound fraction to the
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Patrick M. Honore, David De Bels, Luc Kugener, Sebastien Redant, Rachid Attou, Andrea Gallerani and Herbert D. Spapen
To the editor
Pharmacokinetic and dose-response data suggest a vitamin C (vit C) dose largely exceeding 3 g daily in critically ill patients. We recently proposed higher vit C dosing in cardiac arrest patients who require continuous renal replacement therapy (CRRT).[ 1 ] In a reaction, Spoelstra-de Man et al . rebutted that increasing the vit C dose above 2 g/day during continuous veno-venous hemofiltration (CVVH) was unnecessary when normal plasma vit C concentrations are targeted. They based their standpoint on calculating less vit C removal during CVVH