Paradigma Baru Terapi Leptospirosis Melalui Inovasi dalam Pengobatan Farmakologis dan Non-Farmakologis: Literature Review
DOI:
https://doi.org/10.22225/amj.5.3.2025.261-272Abstract
Leptospirosis merupakan penyakit zoonosis yang disebabkan oleh Leptospira spp., termasuk dalam kelompok Neglected Tropical Diseases (NTDs) dengan prevalensi tinggi di wilayah tropis. Di Indonesia, kasus meningkat pada musim hujan maupun kemarau akibat faktor lingkungan, aktivitas manusia, dan ekologi reservoir. Manifestasi klinis bervariasi dari gejala ringan hingga bentuk berat (penyakit Weil) dengan risiko gagal multi-organ. Selama beberapa dekade, penatalaksanaan leptospirosis bergantung pada terapi antibiotik dan pencegahan konvensional. Namun, keterbatasan efektivitas, potensi resistensi, serta angka mortalitas pada kasus berat menegaskan kebutuhan akan inovasi pengobatan yang lebih komprehensif. Kajian literatur ini mengulas perkembangan terapi farmakologis meliputi formulasi antibiotik terbaru, kombinasi terapi, penggunaan kortikosteroid sebagai adjuvan untuk menekan badai sitokin, serta pengembangan imunoterapi berbasis antibodi monoklonal dan terapi genomik. Di sisi lain, pendekatan non-farmakologis meliputi eksplorasi vaksin generasi baru (rekombinan, DNA, multi-epitop) yang berpotensi memberikan proteksi lintas serovar, meskipun masih menghadapi kendala efektivitas dan kebutuhan uji klinis. Selain itu, terapi herbal seperti Quercus infectoria, Piper betle, dan ekstrak Angelica sinensis menunjukkan aktivitas antimikroba dan imunomodulator menjanjikan, meski memerlukan validasi farmakokinetik dan uji in vivo lebih lanjut. Dengan demikian, manajemen leptospirosis ke depan menuntut integrasi terapi farmakologis dan non-farmakologi.
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