Leptospirosis medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*All patients with leptospirosis require antimicrobial therapy. | |||
====Antimicrobial regimen==== | ====Antimicrobial regimen==== | ||
*1. '''Severe''' <ref>{{cite book | last = LastName | first = FirstName | title = Human leptospirosis guidance for diagnosis, surveillance and control | publisher = World Health Organization | location = Geneva | year = 2003 | isbn = 9241545895 }}</ref> | *1. '''Severe''' <ref>{{cite book | last = LastName | first = FirstName | title = Human leptospirosis guidance for diagnosis, surveillance and control | publisher = World Health Organization | location = Geneva | year = 2003 | isbn = 9241545895 }}</ref> | ||
:* | :* [[Penicillin]] 1.5 million units IV q6h for 7 days | ||
*2. '''Less severe''' | *2. '''Less severe''' | ||
:* Preferred regimen: [[Amoxycillin]] {{or}} [[Ampicillin]] {{or}} [[Doxycycline]] | :* Preferred regimen: [[Amoxycillin]] {{or}} [[Ampicillin]] 0.5-1 g IV q6h for 7 days {{or}} [[Doxycycline]] 100 mg IV/PO up to 100 mg q12h for 7 days {{or}} [[Erythromycin]] | ||
:* Alternative regimen: [[Ceftriaxone]] {{or}} [[Cefotaxime]] {{or}} [[Quinolone]] | :* Alternative regimen: [[Ceftriaxone]] 1 g IV q24h for 7 days {{or}} [[Cefotaxime]] {{or}} [[Quinolone]] | ||
:* Note (1): Treatment with effective antibiotics should be initiated as soon as the diagnosis of leptospirosis is suspected and preferably before the fifth day after the onset of illness | :* Note (1): Treatment with effective antibiotics should be initiated as soon as the diagnosis of leptospirosis is suspected and preferably before the fifth day after the onset of illness | ||
:* Note (2): Clinicians should never wait for the results of laboratory tests before starting treatment with antibiotics because serological tests do not become positive until about a week after the onset of illness, and cultures may not become positive for several weeks. | :* Note (2): Clinicians should never wait for the results of laboratory tests before starting treatment with antibiotics because serological tests do not become positive until about a week after the onset of illness, and cultures may not become positive for several weeks. | ||
:* Note (3): [[Jarisch-Herxheimer]] reaction may develop upon administration of antimicrobial therapy | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 13:44, 19 October 2015
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Leptospirosis medical therapy On the Web |
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Risk calculators and risk factors for Leptospirosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2]
Overview
Antimicrobial therapy is the mainstay of therapy for Leptospirosis. Less severe cases can be treated with either Amoxicillin, Ampicillin, Doxycycline, or Erythromycin. Severe cases may be treated with high doses of intravenous Penicillin. Supportive therapy measures (especially in severe cases) include detoxication and normalization of the hydro-electrolytic balance. Glucose and salt solution infusions may be administered. Dialysis is reserved for patients with severe disease who fail antimicrobial therapy.
Medical Therapy
- All patients with leptospirosis require antimicrobial therapy.
Antimicrobial regimen
- 1. Severe [1]
- Penicillin 1.5 million units IV q6h for 7 days
- 2. Less severe
- Preferred regimen: Amoxycillin OR Ampicillin 0.5-1 g IV q6h for 7 days OR Doxycycline 100 mg IV/PO up to 100 mg q12h for 7 days OR Erythromycin
- Alternative regimen: Ceftriaxone 1 g IV q24h for 7 days OR Cefotaxime OR Quinolone
- Note (1): Treatment with effective antibiotics should be initiated as soon as the diagnosis of leptospirosis is suspected and preferably before the fifth day after the onset of illness
- Note (2): Clinicians should never wait for the results of laboratory tests before starting treatment with antibiotics because serological tests do not become positive until about a week after the onset of illness, and cultures may not become positive for several weeks.
- Note (3): Jarisch-Herxheimer reaction may develop upon administration of antimicrobial therapy
References
- ↑ LastName, FirstName (2003). Human leptospirosis guidance for diagnosis, surveillance and control. Geneva: World Health Organization. ISBN 9241545895.