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dc.contributor.authorK. Niwattayakulen_US
dc.contributor.authorS. Kaewtasien_US
dc.contributor.authorS. Chueasuwanchaien_US
dc.contributor.authorS. Hoontrakulen_US
dc.contributor.authorS. Chareonwaten_US
dc.contributor.authorC. Suttinonten_US
dc.contributor.authorK. Phimdaen_US
dc.contributor.authorW. Chierakulen_US
dc.contributor.authorS. Silpasakornen_US
dc.contributor.authorY. Suputtamongkolen_US
dc.contributor.otherMuang Loei Ram Hospitalen_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherChumphon Hospitalen_US
dc.contributor.otherChaiyapoom Hospitalen_US
dc.contributor.otherMaharaj Nakhon Ratchasima Hospitalen_US
dc.contributor.otherUdon Thani Center Hospitalen_US
dc.identifier.citationClinical Microbiology and Infection. Vol.16, No.8 (2010), 1207-1212en_US
dc.description.abstractPulmonary involvement in leptospirosis is emerging as a common complication of severe leptospirosis. A prospective randomized controlled trial of desmopressin or high-dose (pulse) dexamethasone as adjunctive therapy in 68 patients with pulmonary involvement associated with severe leptospirosis was conducted between July 2003 and October 2006 at five hospitals in Thailand. There were 23 patients in the desmopressin group, 22 in the pulse dexamethasone group, and 23 in a control group who received standard critical care alone. The diagnosis of leptospirosis was confirmed in 52 patients (77%). There were 15 deaths (22%), of which eight patients received desmopressin, four patients received pulse dexamethasone, and three patients received critical care alone (p 0.19). Eight patients with confirmed leptospirosis died (five patients in the desmopressin group, one in the pulse dexamethasone group and two in the control group). The mortality was not significantly different in the desmopressin group or pulse dexamethasone group compared to the control group in both intention-to-treat patients, and in patients with confirmed leptospirosis. There were no serious events associated with desmopressin treatment, although pulse dexamethasone treatment was associated with a significant increase in nosocomial infection. The results of logistic regression analysis revealed that serum bilirubin level was the only significant risk factor associated with mortality (OR 0.759, 95% CI 0.598-0.965, p 0.024). The results obtained in the present study do not support the use of either pulse dexamethasone or desmopressin as adjunct therapy for pulmonary involvement associated with severe leptospirosis. © 2010 The Authors. Journal Compilation © 2010 European Society of Clinical Microbiology and Infectious Diseases.en_US
dc.rightsMahidol Universityen_US
dc.titleAn open randomized controlled trial of desmopressin and pulse dexamethasone as adjunct therapy in patients with pulmonary involvement associated with severe leptospirosisen_US
Appears in Collections:Scopus 2006-2010

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