Comparison of azithromycin vs doxycycline prophylaxis in leptospirosis, A randomized double blind placebo-controlled trial

  • Ahmad Alikhani Mazandaran University of Medical Sciences, Sari, Iran
  • Ebrahim Salehifar Mazandaran University of Medical Sciences, Sari, Iran
  • Fatemeh Zameni Mazandaran University of Medical Sciences, Sari, Iran
  • Alireza Rafiei Mazandaran University of Medical Sciences, Sari, Iran
  • Jamshid Yazdani-charati Mazandaran University of Medical Sciences, Sari, Iran
  • Leila Delavaryan Mazandaran University of Medical Sciences, Sari, Iran
  • Azita Akbari Mazandaran University of Medical Sciences, Sari, Iran
  • Farhang Babamahmoudi Mazandaran University of Medical Sciences, Sari, Iran
Keywords: leptospirosis, chemoprophylaxis, doxycycline, azithromycin, clinical trial

Abstract

Introduction: Leptospirosis is an important zoonotic disease in paddy field with 29.5% prevalence rate in Mazandaran province and 4% to 52% mortality rate among hospitalized patients. Prevention is an important strategy for the control of this disease. This study aimed to compare the prophylactic effect of azithromycin versus doxycycline against leptospirosis in an endemic area in north of Iran.

Methodology: In this randomized double-blind placebo-controlled trial, paddy field workers (n = 187) were randomized to receive azithromycin (500mg weekly), doxycycline (200 mg weekly) or placebo starting one week before exposure to paddy field, during and to four weeks after. Paddy field workers aged 18- 65 years who signed the informed consent form were assessed for signs and symptoms of leptospirosis in addition to serologic evidence of the disease 6th and 12th week. Data were analyzed with SPSS version 13 using Chi-square and Fisher exact test and ANOVA.

Results: From June to September 2016, 187 participants were entered the study to receive azithromycin (n = 66), doxycycline (n = 71) or placebo (n = 50). In terms of preventing against clinical leptospirosis, there was not any significant difference between three arms, though there was statistically significant difference of seropositivity after 6 and 12 weeks in comparison to baseline among all three groups (P = 0.029) and between active treatment (eg. azithromycin and doxycycline) groups and placebo group (P = 0.01).

Conclusion: Azithromycin like doxycycline decreased seropositivity without significant effect on clinical leptospirosis.

Author Biographies

Ebrahim Salehifar, Mazandaran University of Medical Sciences, Sari, Iran

full professor of clinical pharmacyclinical Pharmacy, School of Pharmacy

Fatemeh Zameni, Mazandaran University of Medical Sciences, Sari, Iran

infectious diseases specialist of blood donation centre

Alireza Rafiei, Mazandaran University of Medical Sciences, Sari, Iran

full professor of Immunology, School of Medicine

Jamshid Yazdani-charati, Mazandaran University of Medical Sciences, Sari, Iran

associate professor of biostatistics, Faculty of Health

Leila Delavaryan, Mazandaran University of Medical Sciences, Sari, Iran

Razi Hospital, Ghaemshahr

Farhang Babamahmoudi, Mazandaran University of Medical Sciences, Sari, Iran

full professor in infectious diseases, School of Medicine

Published
2018-11-30
How to Cite
1.
Alikhani A, Salehifar E, Zameni F, Rafiei A, Yazdani-charati J, Delavaryan L, Akbari A, Babamahmoudi F (2018) Comparison of azithromycin vs doxycycline prophylaxis in leptospirosis, A randomized double blind placebo-controlled trial. J Infect Dev Ctries 12:991-995. doi: 10.3855/jidc.10126
Section
Original Articles