Abstract
Serious infectious diseases typically have an unfavorable outcome because they often lead to disseminated intravascular coagulation (DIC), which in turn leads to multiple organ dysfunction due to ischemia. Therefore, it is essential to control the infection and treat DIC simultaneously. Although, antithrombin (AT) is the most recommended drug for the treatment of infectious DIC in Japan, the efficacy of recombinant thrombomodulin (rTM) therapy has also been reported. In this study, we compared the efficacy of rTM monotherapy with that of rTM and AT combination therapy for infectious DIC. There was no significant difference with regard to patient background or disease severity at the time of treatment initiation in both groups. Furthermore, the rate of recovery from DIC within 7 days and the rate of recovery, survival rate after 28 days were not significantly different between the two groups. rTM administration could improve the markers of inflammation, coagulation, fibrinolysis, and Japanese association for acute medicine (JAAM) DIC diagnostic criteria score significantly, but there were no significant differences between two groups. Considering these findings, the prognosis for patients with infectious DIC may not necessarily improve by adding AT to rTM, and as such, rTM monotherapy may be considered equally efficacious as rTM and AT combination therapy.
