title: Single dosage of doxycycline for prophylaxis against leptospiral infection and leptospirosis during urban flooding in southern Thailand: a non-randomized controlled trial.
abstract: This study was conducted to investigate the protective efficacy of a single dosage of 200 mg doxycycline against leptospiral infection and leptospirosis and associated risk factors among residents exposed to flooding in southern Thailand. Of 641 participants, 600 received doxycycline while 41 did not. Twenty two participants were infected with Leptospira and six developed leptospirosis. Having a laceration wound was significantly associated with leptospiral infection (odds ratio [OR] = 37.20; P < 0.001) and leptospirosis (OR = 18.24; P = 0.003) whereas exposure to flood more than 3 h per day was associated with only leptospiral infection (OR = 3.70; P = 0.038). Seventeen participants who received doxycycline and five who did not, were infected with Leptospira, resulting a protective efficacy of 76.8% (95% confidence interval [CI] = 34.3%-92.0%). Four who received doxycycline and two who did not, developed leptospirosis, resulting a protective efficacy of 86.3% (CI = -9.8%-98.2%). Among the participants with laceration wound, the protective efficacy for leptospiral infection was 92.0% (CI = 81.2%-96.6%) and for leptospirosis was 95.6% (CI = 78.2%-99.3%). Among the participants exposed to flood water less than or equal to 3 h per day, the protective efficacy for leptospiral infection was 89.2% (95% CI 63.6%-96.67%). 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.
authors.affiliation: Division of Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. Electronic address: sarunyouchusri@hotmail.com.
authors.forename: Sarunyou
authors.initials: S
authors.lastname: Chusri
authors.affiliation: Epidemiology Unit, Department of Community Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Edward B
authors.initials: EB
authors.lastname: McNeil
authors.affiliation: Division of Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Thanaporn
authors.initials: T
authors.lastname: Hortiwakul
authors.affiliation: Division of Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Boonsri
authors.initials: B
authors.lastname: Charernmak
authors.affiliation: Division of Serology, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Somporn
authors.initials: S
authors.lastname: Sritrairatchai
authors.affiliation: Department of Pharmacy, Faculty of Pharmacy, Silapakorn University, Nakornpathom, Thailand.
authors.forename: Wichai
authors.initials: W
authors.lastname: Santimaleeworagun
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Sutthiporn
authors.initials: S
authors.lastname: Pattharachayakul
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Prince of Songkla University, Songkhla, Thailand.
authors.forename: Paritasana
authors.initials: P
authors.lastname: Suksanan
authors.affiliation: Department of Virology, Armed Forces Research Institute of Medial Sciences, Bangkok, Thailand.
authors.forename: Butsaya
authors.initials: B
authors.lastname: Thaisomboonsuk
authors.affiliation: Department of Virology, Armed Forces Research Institute of Medial Sciences, Bangkok, Thailand.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Jarman
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002947:Cities; D004318:Doxycycline / Q000008:administration & dosage*; D005260:Female; D055868:Floods; D006801:Humans; D022125:Lacerations / Q000453:epidemiology; D007922:Leptospirosis / Q000453:epidemiology / Q000517:prevention & control*; D008875:Middle Aged; D065228:Non-Randomized Controlled Trials as Topic; D012307:Risk Factors; D013785:Thailand; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline
keywords: Doxycycline; Flooding; Leptospirosis; Prophylaxis