Ceftriaxone compared with sodium penicillin g for treatment of severe leptospirosis.
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.
Panaphut
Thanachai
T
Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand.
Domrongkitchaiporn
Somnuek
S
Vibhagool
Asda
A
Thinkamrop
Bandit
B
Susaengrat
Wattanachai
W
D000328:Adult; D002443:Ceftriaxone / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007922:Leptospirosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use*; D010406:Penicillins / Q000627:therapeutic use*; D011446:Prospective Studies; D013785:Thailand; D016896:Treatment Outcome
D002511:Cephalosporins; D010406:Penicillins; D002443:Ceftriaxone; D010400:Penicillin G