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Am. J. Trop. Med. Hyg., 39(4), 1988, pp. 388-390
Copyright © 1988 by The American Society of Tropical Medicine and Hygiene

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Penicillin Therapy in Icteric Leptospirosis

Charles N. Edwards, George D. Nicholson, Trevor A. Hassell, Christopher O. R. Everard AND Joy Callender
Department of Medicine, Queen Elizabeth Hospital, Faculty of Medical Sciences, University of the West Indies, and the MRC/Barbados Government Leptospira Laboratory, St. Michael, Barbados

A prospective, controlled randomized study of penicillin therapy in icteric human leptospirosis was carried out between 1 October 1983 and 31 December 1986. Thirty-eight patients received intravenous crystalline penicillin for 5 days, while 41 assigned to a control group received intravenous fluids only. A comparison of the results of laboratory tests made on the day of admission revealed no significant differences between the 2 groups. There was no significant difference in time for defervescence, return of biochemical parameters to normal, incidence of iritis, or mortality in the 2 groups. Three patients (7.3%) in the control group and 1 patient (2.6%) in the treatment group died. The overall mortality rate was 5.9%. Leptospira were recovered from urine cultures in 6 control patients but from none of the treated patients' post-treatment cultures. We conclude that penicillin has little effect on clinical outcome in icteric leptospirosis.




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