Corticosteroids for treatment of leptospirosis

Abstract

Based on the very low certainty of evidence attributable to our analyses, we do not know whether corticosteroids compared with no intervention, no intervention beyond standard of care, or placebo, reduce all-cause mortality, increase the risk of serious or non-serious adverse events, decrease days of hospitalisation, or decrease the proportion of people experiencing Jarisch-Herxheimer reaction events. None of the four trials assessed health-related quality of life. There is a lack of harmonised treatment strategies, clinically relevant outcome definitions, and definitive and rigorously designed randomised trials to support the use of corticosteroids for leptospirosis. Future research should focus on these evidence gaps.