(Part 1 covered leptospirosis clinical presentations, diagnostic findings, and establishing a diagnosis; including images. Part 2 continues with treatment options.—Ed.)

Treatments for leptospirosis

Antibacterial therapy. Surprisingly, several studies have failed to demonstrate improved outcomes in people with leptospirosis treated with antibiotics versus those receiving a placebo; this is likely a reflection of the impact of the host immune response on the clinical manifestations and consequences of infection.²⁰ Despite a dearth of hard evidence, antibiotics are recommended by the World Health Organization (WHO). From the veterinary perspective, expert opinion supports empirical administration of an appropriate antibiotic in a canine patient with a reasonable index of suspicion for leptospirosis.^1,21

Antibiotics should not be withheld until infection is confirmed, as a delay may impact patient outcome and increases the risk of infection for those handling the animal. Various antibiotics have some efficacy against leptospires, but penicillins and doxycycline remain the initial drugs of choice.