From the Research
The recommended treatment for leptospirosis is antibiotics, with doxycycline and penicillin being the primary options, and ceftriaxone as an effective alternative for those with penicillin allergies. For mild cases, oral doxycycline 100mg twice daily for 7 days is typically prescribed 1. For severe cases requiring hospitalization, intravenous penicillin G at 1.5 million units every 6 hours for 7 days is the standard approach, as demonstrated by a prospective, open-label, randomized trial 2. Alternatively, ampicillin or amoxicillin can be used. Ceftriaxone 1g daily for 7 days is an effective alternative for those with penicillin allergies, with a study showing its efficacy in treating severe leptospirosis 3.
Key Considerations
- Treatment should begin as soon as leptospirosis is suspected, without waiting for laboratory confirmation, as early intervention significantly improves outcomes.
- Supportive care is also essential, including fluid replacement, pain management, and fever control.
- In severe cases with kidney or liver involvement, dialysis or intensive care may be necessary.
- Antibiotics work by eliminating the Leptospira bacteria from the bloodstream and tissues, preventing further damage to organs such as the kidneys, liver, and lungs.
- Prompt treatment is crucial as it can shorten the illness duration and reduce the risk of complications, as highlighted in a review of antimicrobial therapy for leptospirosis 4. Some studies have also explored the use of corticosteroids in severe cases, but this approach is not widely recommended and should be considered on a case-by-case basis 5.