Related Experiment Video

Updated: May 28, 2026

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
06:09

Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis

Published on: July 18, 2017

Leptospirosis-associated acute kidney injury: penicillin at the late stage is still controversial

E F Daher1, G B Silva, K L S de Abreu

  • 1Post-Graduation Program in Medical Sciences, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil. ef.daher@uol.com.br

Journal of Clinical Pharmacy and Therapeutics
|October 25, 2011
PubMed
Abstract

Insights

Penicillin treatment for leptospirosis may reduce hospital stays and complications like acute kidney injury (AKI), but does not decrease mortality. Researchers recommend penicillin for late-stage leptospirosis based on a risk-benefit analysis.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Pharmacology

Background:

  • Leptospirosis is a bacterial infection with potential kidney complications.
  • The efficacy of penicillin in treating late-stage leptospirosis, particularly with acute kidney injury (AKI), remains debated.
  • Antimicrobial agents show in vitro activity against Leptospira.

Purpose of the Study:

  • To evaluate the effectiveness of penicillin in patients with leptospirosis-associated acute kidney injury (AKI).
  • To assess the impact of penicillin on clinical outcomes, including renal function and mortality, in leptospirosis patients.

Main Methods:

  • Retrospective study of 287 patients with leptospirosis admitted to hospitals in Fortaleza, Brazil (1985-2008).
  • Patients were categorized into two groups: those treated with penicillin and those not.
  • Acute kidney injury (AKI) was classified using RIFLE and AKIN criteria.

Main Results:

  • Patients treated with penicillin were younger and had shorter hospital stays.
  • Penicillin use was associated with a lower incidence of AKI, need for dialysis, and improved renal recovery.
  • No significant difference in mortality rates was observed between the penicillin and non-penicillin groups.

Conclusions:

  • Penicillin treatment in late-stage leptospirosis may reduce hospital stay duration and complications like AKI.
  • While not reducing mortality, penicillin offers benefits in managing leptospirosis-associated kidney injury.
  • The study recommends penicillin use in late-stage leptospirosis, balancing risks and benefits.

More Related Videos

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...