Ceftriaxone compared with sodium penicillin g for treatment of severe leptospirosis.
Author(s): Panaphut T, Domrongkitchaiporn S, Vibhagool A, Thinkamrop B, Susaengrat W
Affiliation(s): Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand.
Publication date & source: 2003-06-15, Clin Infect Dis., 36(12):1507-13. Epub 2003 Jun 6.
Publication type: Clinical Trial; Randomized Controlled Trial
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. 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.
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