Raptis Lampros, Pappas Georgios, Akritidis Nikolaos
Internal Medicine Department, General Hospital 'G. Hatzikosta', Makrygianni Avenue, 45500 Ioannina, Greece.
Int J Antimicrob Agents. 2006 Sep;28(3):259-61. doi: 10.1016/j.ijantimicag.2006.04.011. Epub 2006 Aug 7.
The optimal treatment of severe and late leptospirosis, and even the need for antibiotic treatment in such clinical settings, remains a subject of debate. Twenty-two patients with severe late leptospirosis were treated with intravenous ceftriaxone 2g daily. Twenty-one patients recovered and one patient passed away due to respiratory complications of the disease. The adverse effect profile and the convenience of the regimen were superior to penicillin regimens reported in other clinical trials. Ceftriaxone may be a reasonable alternative in severe leptospirosis as an efficient, convenient and safe regimen. Large multicentre studies may further define the optimal interventions in severe leptospirosis as well as possible variations in the pathogenic and clinical parameters of respiratory leptospirosis.
严重和晚期钩端螺旋体病的最佳治疗方法，甚至在此类临床情况下是否需要抗生素治疗，仍然是一个有争议的话题。22例严重晚期钩端螺旋体病患者接受了每日2克静脉注射头孢曲松的治疗。21例患者康复，1例患者因该病的呼吸并发症死亡。该治疗方案的不良反应情况和便利性优于其他临床试验中报道的青霉素治疗方案。头孢曲松作为一种高效、方便且安全的治疗方案，可能是严重钩端螺旋体病的合理替代选择。大型多中心研究可能会进一步明确严重钩端螺旋体病的最佳干预措施，以及呼吸型钩端螺旋体病在致病和临床参数方面可能存在的差异。
