A Scoping Review of Antimicrobial Therapy in Leptospira Infections in Domestic Animals

家畜钩端螺旋体感染抗菌治疗的范围综述

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Abstract

Leptospirosis, caused by Leptospira spp., affects multiple domestic species and can result in significant economic and public health impacts. This scoping review, conducted following the PRISMA 2020 guidelines, searched PubMed, SciELO, and Scopus for original studies that described complete therapeutic protocols (including dose, duration, and confirmed diagnosis) in dogs, cats, cattle, pigs, horses, sheep, and goats. Thirty-five studies met the criteria: 14 (40%) in cattle, 7 (20%) in swine, 2 (5.7%) in small ruminants, 7 (20%) in dogs and cats, and 5 (14.3%) in horses. In livestock, streptomycin monotherapy has predominated, demonstrating high efficacy against renal and genital carriers, but it faces regulatory restrictions in several countries. In companion animals, treatment often addressed acute cases using doxycycline and aminopenicillins, with frequent drug combinations. Horses were mainly treated with penicillin, alone or associated with other agents. Across species, protocols showed substantial heterogeneity, lack of harmonization, and limited evaluation of bacteriological cure, with most studies published before 2000. This scarcity of recent clinical trials reinforces the neglected status of animal leptospirosis. By compiling fragmented evidence, this review identifies converging practices that may serve as a preliminary consensus, highlights discrepancies and knowledge gaps, and provides an evidence-based framework to support the development of standardized, species-specific guidelines urgently needed in a One Health context.

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