Treatment of Severe Leptospirosis with Renal Failure and Hepatic Failure in Adults

This protocol covers the management of severe leptospirosis in non-pregnant adults who present with concurrent renal failure and hepatic failure — a high-acuity clinical situation requiring prompt antibiotic intervention alongside targeted supportive care.

Clinical Scenario

Renal Failure Hepatic Failure Non-pregnant Adult

Severe leptospirosis in this population typically presents with simultaneous kidney and liver involvement. The co-occurrence of renal and hepatic failure defines the severity tier and directly shapes the choice and route of antibiotic therapy.

Treatment Approach (Partial Overview)

Intravenous antibiotic therapy is the cornerstone of treatment in this presentation, with multiple antibiotic options available depending on the clinical context. Supportive care to maintain electrolyte and fluid balance is recommended alongside antibiotic treatment. The complete antibiotic selection, alternatives, and supportive care protocol are available in the full structured regimen.

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References

DOI: 10.3389/fmicb.2024.1403765

Patients with severe leptospirosis, which normally manifests as renal and hepatic failure, are administered penicillin G (penicillin G sodium; at a dose of 1.5 million U/6 h) intravenously.
It should be used for a week.
In accordance with reported records, amoxicillin, ampicillin, azithromycin, doxycycline and tetracycline can also be used for the treatment of severe leptospirosis.
In addition to the aforementioned antibiotics, the antibiotics cefotaxime and/or ceftriaxone are effective choices for the treatment of leptospirosis.
To maintain homeostatic electrolyte and fluid conditions, supportive therapy is recommended.

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