Current antibiotics for leptospirosis: Are still effective?

Leptospirosis is a recurring zoonotic disease of global significance. Leptospirosis is curable, and antibiotics are available for its treatment. However, little is known about the effectiveness of the currently used antibiotics against different Leptospira species, serovars, and strains. This review aimed to give insight into the anti-leptospiral activities of the currently available antibiotics towards Leptospira strains and their effectiveness in treating and preventing leptospirosis. Anti-leptospiral activities from natural resources were also reviewed. The literature search was conducted using several databases. The majority of Leptospira strains were sensitive to the current antibiotics. Antibiotics can accelerate the defervescence and reduced the occurrence of leptospirosis cases, nevertheless, there is no affirmative evidence on the beneficial effects of the antibiotics compared to placebo in preventing death. Adverse reactions like Jarisch-Herxheimer reactions (JHR) in patients treated with the current antibiotics were also reported. Plants, marine actinobacteria and propolis are shown as potential sources of new anti-leptospiral compounds. Although leptospirosis can still be adequately treated with current antibiotics, continuous susceptibility testing and the development of novel antibiotics especially from natural resources are highly encouraged.