Treatment of Leptospirosis

The author emphasizes the impor­tance of early antibiotic treatment of leptospirosis, which should comprise penicillin G two million IU every four hours for seven days. This therapy is effec­tive even when instituted later than four days after onset of illness. It prevents eye inflammation caused directly by leptospires. It also reduces the rate of autoimmune complications. Tetracycline and doxycicline are indicated in patients with allergy to penicillin. Patients with Weil’s syndrome should be cared for in the intensive care units. Continuous monitoring of clin­ical status is imperative so that all problems asso­ciated with renal and hepatic failure, shock, hemorrhage or involvement of the central ner­vous system can be promptly attended to. Shock occurring at the onset of illness is managed in the same way as shock caused by other gram­negative bacteria.