Leptospirosis (Weil’s Disease): Drug Therapy

Therapeutic targets

• Elimination of the pathogens
• Avoidance of complications

Therapy recommendations

• It is unclear whether antibiotic therapy is effective because organ manifestations are essentially due to an immune response.
• If antibiotic therapy is given, it should be started as early as only possible!
• Selection of antibiotics according to the severity of the disease process:
  • Mild course of the disease: doxycycline (tetracyclines).
  • Severe courses of disease: penicillin G or ceftriazone (cephalosporins).
• The duration of therapy is 7 days in each case.
• Cave (Caution)!There may be a Jarisch-Herxheimer reaction (reaction of the body to endotoxins (bacterial toxins), which are produced by the therapy-related decay of a large amount of pathogens and lead to the release of inflammatory messengers; duration: one to several days) in a few hours after the start of therapy, which is treated symptomatically.
• Depending on the severity of the disease, other organ systems must be treated with.
• See also under “Further therapy”.