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PSM · Communicable diseases: leptospirosis prophylaxis
Sample itemAfter heavy rains, a group of paddy field workers must wade in flooded water for several weeks in a leptospirosis-endemic area. Which chemoprophylaxis is recommended for them?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Doxycycline 200 mg once weekly
Leptospirosis spreads through contact of broken skin or mucosa with water contaminated by rat urine. Doxycycline 200 mg once weekly is recommended for high-risk exposure such as flood work, and the same drug at treatment doses is used for mild disease. Other measures include rodent control, protective footwear and avoiding wading when possible.
Option by option
A. Doxycycline 200 mg once weekly (correct)
Correct. Weekly doxycycline is the standard prophylaxis for occupational exposure.
B. Benzathine penicillin monthly
Monthly benzathine penicillin is not the recommended prophylactic regimen for leptospirosis.
C. Ciprofloxacin 500 mg daily
Daily ciprofloxacin is not recommended for leptospirosis prophylaxis.
D. Chloroquine 300 mg once weekly
Chloroquine is a malaria drug and has no action against leptospires.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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