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

May 31, 2013 at 2:30 pm

Clin Infect Dis. 2003 Jun 15;36(12):1507-13.

Panaphut T, Domrongkitchaiporn S, Vibhagool A, Thinkamrop B, Susaengrat W.

Source

Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand.

Abstract

A prospective, open-label, randomized trial at KhonKaenHospital (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. 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). The primary outcome was time to fever resolution. Survival analysis demonstrated that the median duration of fever was 3 days for both groups. Ten patients (5 in each group) died of leptospirosis infection. There were no statistically significant differences in the duration of organ dysfunction. Ceftriaxone and sodium penicillin G were equally effective for the treatment of severe leptospirosis. Once-daily administration and the extended spectrum of ceftriaxone against bacteria provide additional benefits over intravenous penicillin.

PDF

http://cid.oxfordjournals.org/content/36/12/1507.full.pdf+html

 

Comment in

A mountain out of a molehill – do we treat acute leptospirosis, and if so, with what? [Clin Infect Dis. 2003]

PDF

http://cid.oxfordjournals.org/content/36/12/1514.full.pdf+html

 

Comment: Important open label clinical trial comparing the use of ceftriaxone vs. penicillin for the treatment of severe leptospirosis; the two were equivalent, but late initiation of Rx does not always forestall death in severe cases.

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Metodos diagnosticos, Sepsis, Zoonosis.

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