Ceftriaxone compared with sodium penicillin g for treatment of severe leptospirosis

Clin Infect Dis. 2003 Jun 15;36(12):1507-13. doi: 10.1086/375226. Epub 2003 Jun 6.


A prospective, open-label, randomized trial at Khon Kaen Hospital (Thailand) was conducted from July 2000 through December 2001 to compare the clinical efficacies of ceftriaxone and sodium penicillin G for the treatment of severe leptospirosis. A total of 173 patients with severe leptospirosis were randomly assigned to be treated with either intravenous ceftriaxone (1 g daily for 7 days; n=87) or intravenous sodium penicillin G (1.5 million U every 6 h for 7 days; n=86). The primary outcome was time to fever resolution. Survival analysis demonstrated that the median duration of fever was 3 days for both groups. Ten patients (5 in each group) died of leptospirosis infection. There were no statistically significant differences in the duration of organ dysfunction. Ceftriaxone and sodium penicillin G were equally effective for the treatment of severe leptospirosis. Once-daily administration and the extended spectrum of ceftriaxone against bacteria provide additional benefits over intravenous penicillin.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ceftriaxone / therapeutic use*
  • Cephalosporins / therapeutic use*
  • Female
  • Humans
  • Leptospirosis / drug therapy*
  • Male
  • Middle Aged
  • Penicillin G / therapeutic use*
  • Penicillins / therapeutic use*
  • Prospective Studies
  • Thailand
  • Treatment Outcome


  • Cephalosporins
  • Penicillins
  • Ceftriaxone
  • Penicillin G