Leptospirosis responds well to treatment, especially if started early in the illness. OR amoxicillin 500 mg po qid. Jarisch-Herxheimer reactions to therapy may occur, i.e., acute febrile reaction, accompanied by headache and myalgia due to release of toxic products of killed spirochetes. The reaction usually occurs within 24 hours of initiation of therapy and subsides about 24 hours later. Therapy is continued unless symptoms are severe.
Renal failure is treated as in other circumstances.
Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group. Randomized controlled trial of doxycycline prophylaxis against leptospirosis in an endemic area. International Journal of antimicrobial agents .