Ceftriaxone compared with sodium penicillin G for treatment of severe leptospirosis

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Abstract

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 iyntravenous penicillin.

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Panaphut, T., Domrongkitchaiporn, S., Vibhagool, A., Thinkamrop, B., & Susaengrat, W. (2003). Ceftriaxone compared with sodium penicillin G for treatment of severe leptospirosis. Clinical Infectious Diseases, 36(12), 1507–1513. https://doi.org/10.1086/375226

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