Use of ceftriaxone in patients with severe leptospirosis.

The optimal treatment of severe and late leptospirosis, and even the need for antibiotic treatment in such clinical settings, remains a subject of debate. Twenty-two patients with severe late leptospirosis were treated with intravenous ceftriaxone 2g daily. Twenty-one patients recovered and one patient passed away due to respiratory complications of the disease. The adverse effect profile and the convenience of the regimen were superior to penicillin regimens reported in other clinical trials. Ceftriaxone may be a reasonable alternative in severe leptospirosis as an efficient, convenient and safe regimen. Large multicentre studies may further define the optimal interventions in severe leptospirosis as well as possible variations in the pathogenic and clinical parameters of respiratory leptospirosis.