Ceftriaxone compared with sodium penicillin g for treatment of severe leptospirosis.

@article{Panaphut2003CeftriaxoneCW,
  title={Ceftriaxone compared with sodium penicillin g for treatment of severe leptospirosis.},
  author={Thanachai Panaphut and Somnuek Domrongkitchaiporn and Asda Vibhagool and Bandit Thinkamrop and Wattanachai Susaengrat},
  journal={Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
  year={2003},
  volume={36 12},
  pages={
          1507-13
        }
}
A prospective, open-label, randomized trial at Khon Kaen Hospital (Thailand) was conducted from July 2000 through December 2001 to compare the clinical efficacies of ceftriaxone and sodium penicillin G for the treatment of severe leptospirosis. [] Key Method A total of 173 patients with severe leptospirosis were randomly assigned to be treated with either intravenous ceftriaxone (1 g daily for 7 days; n=87) or intravenous sodium penicillin G (1.5 million U every 6 h for 7 days; n=86).
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TLDR
Prophylactic therapy for high-risk individuals or prompt diagnosis and early treatment (before 4 days of symptoms) appear to be cost-effective approaches to prevent severe complications of leptospirosis.
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TLDR
This review summarizes the most recent literature pertaining to the use of antimicrobial agents in the treatment of leptospirosis and indicates that penicillin, doxycycline, cefotaxime, ceftriaxone and azithromycin may be the preferred agents at this time.
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The risks and benefits associated with use of antibiotic therapy in the management of leptospirosis were characterised and trends towards increased dialysis when penicillin was used rather than placebo, but the estimate of effect was small and did not reach statistical significance.
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