What is the role of doxycycline in the treatment of leptospirosis?

Updated: Jul 08, 2021
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Doxycycline, in the dose of 200 mg every week, has demonstrated efficacy of 95% against leptospirosis and may help prevent the disease in exposed adults. [56, 57]  The role of prophylaxis in children has not been adequately studied, however, animal studies support its use in prophylaxis.

Episodic prophylaxis with antibiotics is recommended for those with short-term exposure and is not for repeated or long-term exposure in endemic areas. A randomized placebo-controlled trial comparing doxycyline and azithromycin prophylaxis in Iranian paddy field workers showed statistically significant reduction in seropositivity associated with either antibiotic versus placebo after 6 and 12 weeks. No difference was observed in incidence of clinical disease. [58]


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