Steroid benefits and harms remain uncertain for leptospirosis
Trials in hospital patients with leptospirosis did not establish whether corticosteroids improve survival compared with usual care alone or placebo. Evidence was very uncertain for both benefits and harms.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
For people hospitalized with leptospirosis, a bacterial disease, the review could not establish whether corticosteroids improve survival or change serious adverse-event rates. The mortality estimate allowed for both benefit and harm. Other outcomes were similarly uncertain, so the abstract supports an unresolved treatment question rather than a conclusion that steroids help or are ineffective.
All evaluated outcomes had very low-certainty evidence. Trial bias concerns, differing results, and imprecise estimates weakened confidence. None of the trials assessed health-related quality of life.
What researchers found
All-cause mortality
Corticosteroids versus usual care alone or placebo: risk ratio 1.04, 95% confidence interval 0.38 to 2.80, at each trial's longest follow-up; follow-up lengths were not reported.
The mortality estimate leaves room for different outcomes
A risk ratio compares death risk between treatment groups. Here, its confidence interval spans values compatible with fewer or more deaths with corticosteroids. That uncertainty prevents interpreting the central estimate as evidence of equivalent survival.
Safety was also unresolved
The review examined serious and less serious adverse events, hospital stay, and a named reaction outcome. Its authors judged the evidence insufficient to determine these effects reliably, so an uncertain survival result does not establish safety.
The original publication
Corticosteroids for treatment of leptospirosis.
Lee N, Han SM, Mukadi P et al.
Cochrane Database Syst Rev · 2025
- PubMed ID
- 40704556
- Record checked
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