Treatment and prevention of leptospirosis

Treatment and prevention of leptospirosis

Author
E Dale Everett, MD
Section Editors
Stephen B Calderwood, MD
Morven S Edwards, MD
Deputy Editor
Elinor L Baron, MD, DTMH
Disclosures
All topics are updated as new evidence becomes available and our peer review process is
complete.
Literature review current through: Oct 2012. | This topic last updated: Nov 6, 2009.
INTRODUCTION Leptospirosis is a zoonosis with protean manifestations caused by the
spirochete Leptospira interrogans. Synonyms for the disease include Weil's disease, Swineherd's
disease, rice-field fever, cane-cutter fever, swamp fever, mud fever, hemorrhagic jaundice,
Stuttgart disease, and Canicola fever.
The treatment and prevention of leptospirosis will be presented here. The epidemiology,
microbiology, clinical manifestations, and diagnosis of this disease are discussed separately. (See
"Microbiology, epidemiology, clinical manifestations, and diagnosis of leptospirosis".)
TREATMENT The vast majority of infections with Leptospira are self-limiting. Although
penicillins, tetracyclines, chloramphenicol, and erythromycin have antileptospiral activity in
vitro and in animal models, it remains controversial whether antimicrobials produce a beneficial
effect in mild human leptospirosis since the illness has a variable natural history. Nevertheless, if
the illness is severe enough to result in a physician visit and the diagnosis is recognized,
antibiotic therapy should be given.