Treatment patterns and outcomes of patients hospitalized for leptospirosis in endemic and non-endemic regions in Japan, 2010-2023: A nationwide inpatient database study.

Abstract

Introduction: Leptospirosis is endemic to Okinawa but non-endemic to other regions (non-Okinawa) of Japan. We evaluated the characteristics, treatment, and outcomes of patients with leptospirosis in and outside Okinawa.

Methods: Using a Japanese national inpatient database, we identified patients hospitalized with leptospirosis between 2010 and 2023. Data on patient characteristics, antibiotic treatment, need for intensive care, and outcomes were collated and compared between patients in and outside Okinawa.

Results: Among 342 patients, 162 were hospitalized in Okinawa, whereas 180 outside Okinawa. Okinawan patients were younger than non-Okinawan patients (median age: 35.5 vs. 54 years). Over 80 % received beta-lactams. Broad-spectrum beta-lactams or combination therapy with tetracyclines were administered more commonly outside Okinawa. Patients outside Okinawa required intensive care more frequently. The overall mortality rate was 1.2 %.

Conclusion: Antimicrobial prescription patterns and intensive care requirements varied between the two regions. These disparities may be attributed to variations in physicians' diagnostic thresholds or diagnostic delays outside Okinawa.