Ceftriaxone Compared with Sodium Penicillin G for Treatment of Severe Leptospirosis
Wattanachai Susaengrat, ธนชัย พนาวุฒิ, บัณฑิต ถิ่นคำรพ, สมนึก ดำรงกิจชัยพร*, อัษฎา วิภากุล
Division of Nephrology, Dept. of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand (rasdr@mahidol.ac.th)
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.
Clinical Infectious Diseases ปี 2546, June ปีที่: 36 ฉบับที่ 12 หน้า 1507-1513