polymyxin B + thrombomodulin

Polymyxin B + thrombomodulin is a combination therapy used primarily in the management of septic shock associated with disseminated intravascular coagulation (DIC). Polymyxin B is an antibiotic that disrupts the outer membrane of Gram-negative bacteria, neutralizes lipopolysaccharide (LPS), and inhibits bacterial respiration, thereby reducing endotoxin-mediated inflammation[8][10]. Thrombomodulin, often administered as recombinant human soluble thrombomodulin (rTM), is an endothelial cell surface glycoprotein that acts as a cofactor for thrombin. It converts thrombin from a procoagulant to an anticoagulant enzyme by facilitating activation of protein C, which in turn inactivates factors Va and VIIIa, suppressing further thrombin generation and exerting anti-inflammatory effects[6][7][9]. The combination aims to address both infection/inflammation (via polymyxin B) and dysregulated coagulation/anti-inflammation (via thrombomodulin). Clinical studies suggest this combination may improve survival rates in patients with sepsis-induced DIC by interrupting the cycle of cytokine storm and multiple organ failure[1][2][3][4].