Leptospirosis is a
zoonotic disease prevalent mainly in developing countries and is associated with high case fatality.
Antibiotics especially
penicillin are the mainstay of treatment for a suspected or confirm case of
leptospirosis but role of
Penicillin has not been evaluated systematically in the light of current evidence. The present systematic review and meta-analysis is done to evaluate the role of
antibiotics in the treatment of
leptospirosis. Parallel group clinical trials involving use of
penicillin in treatment of
leptospirosis were searched from all available sources. Ten clinical trials were found suitable as per laid inclusion criteria eligible for present systematic review and five clinical trials were included in meta-analysis. Clinical trials included for meta-analysis were compared on the basis of mortality,
fever days, numbers of patients presenting with
oliguria, and number of patients undergoing need-based dialysis. Analysis was done by comprehensive meta-analysis software 2. Qualitative outcomes are summarized as odds ratio and quantitative outcomes are summarized as standard mean difference with 95% confidence interval. Random and fixed models are used for analysis. There was no significant difference between
penicillin group and controlled group for mortality (Odds ratio 1.59 (95% CI 0.59-4.29), P = 0.35),
fever days (std difference in mean = -0.223 (95% CI 0.394-0.995), P = 0.358), number of patients presenting with
oliguria (Odds ratio 1.795 (95% CI 0.325-9.929), P = 0.502), and number of patients who underwent need based dialysis (Odds ratio 1.587 (95% CI 0.919-2.731), P = 0.098). Role of various
antibiotics in treatment of
leptospirosis is uncertain, and can be attributed to nonavailability of adequate clinical trials. Role of
penicillin in the treatment of
leptospirosis can be debated.