From the Research
The treatment for leptospirosis acquired through flood water primarily involves antibiotics, with doxycycline being a potential option for prophylaxis, as a single dose of doxycycline at exposure to flood water could have a beneficial effect, as shown in a meta-analysis 1.
Key Considerations
- The most recent and highest quality study, a meta-analysis published in 2021 1, found that a single dose of doxycycline at exposure to flood water could have a beneficial effect in preventing leptospirosis.
- The study also found that there is no evidence that antibiotics are better than placebo in terms of mortality, shortening of fever, liver and kidney function, or reduction in hospital stay.
- Other studies, such as the one published in 2014 2, have also shown that a single dosage of 200 mg doxycycline for prophylaxis might be effective for preventing leptospirosis among flood victims with laceration wound after recent flood exposure.
Treatment Approach
- Doxycycline may be considered as a prophylactic option for individuals exposed to flood water, particularly those with laceration wounds, as it has shown potential in reducing the risk of leptospirosis.
- Supportive care, including adequate hydration, fever management with acetaminophen, and rest, is also essential in the treatment of leptospirosis.
- In severe cases with organ involvement, hospitalization may be necessary for intensive monitoring and support of kidney and liver function.
Limitations and Future Directions
- The current evidence is limited, and well-designed clinical trials are urgently needed to improve our understanding of the treatment for leptospirosis.
- Future studies should consider the heterogeneity of affected communities, improved estimates of the effect of chemoprophylaxis on leptospirosis infection and disease, as well as potential detrimental impacts, as highlighted in a study published in 2017 3.