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Antibiotics for preventing leptospirosis.

F Guidugli1, A A Castro, A N Atallah

  • 1Internal Medicine, Federal University of Sao Paulo, Rua Humberto I, 962 apt. 16, Sao Paulo, Sao Paulo, Brazil, 04018-033. cochrane.dmed@epm.br

The Cochrane Database of Systematic Reviews
|October 18, 2000
PubMed
Summary

Doxycycline prophylaxis significantly reduced symptomatic leptospirosis in soldiers compared to placebo. However, it also increased adverse events, suggesting careful consideration for its use in high-risk populations.

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Area of Science:

  • Infectious Diseases
  • Preventive Medicine
  • Clinical Trials

Background:

  • Leptospirosis is an animal-borne infectious disease with a significant mortality rate (approximately 5%).
  • Doxycycline is commonly prescribed for leptospirosis prevention in clinical settings.
  • Evaluating antibiotic prophylaxis efficacy and safety is crucial for public health.

Purpose of the Study:

  • To assess the effectiveness of antibiotic regimens in preventing leptospirosis.
  • To evaluate the safety profile of antibiotic prophylaxis for leptospirosis.
  • To compare antibiotic prophylaxis against placebo or other antibiotic regimens.

Main Methods:

  • Systematic review of randomized clinical trials (RCTs) on antibiotic prophylaxis for leptospirosis.

Related Experiment Videos

  • Searches across multiple databases (EMBASE, LILACS, MEDLINE, SCISEARCH, Cochrane Registers) without date or language restrictions.
  • Inclusion of RCTs involving individuals at risk of leptospirosis exposure, comparing antibiotic regimens to control groups.

    • Main Results:

    • Two RCTs met criteria, both comparing doxycycline to placebo; no trials compared doxycycline with other antibiotics or vice versa.
    • Doxycycline prophylaxis significantly reduced symptomatic leptospirosis (0.6% vs. 4.9%, NNT=24).
    • Adverse events were higher in the doxycycline group (3% vs. 0.2%, NNH=39).

    Conclusions:

    • Doxycycline prophylaxis appears effective in preventing leptospirosis among soldiers in endemic areas.
    • The observed increase in adverse events warrants careful consideration of doxycycline use.
    • Further research is needed to confirm applicability to other populations and scenarios.