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Antibiotics for preventing meningococcal infections
Anca Zalmanovici Trestioreanu1, Abigail Fraser, Anat Gafter-Gvili
1Department of Family Medicine, Beilinson Campus, Rabin Medical Center, 39 Jabotinski Street, Petah Tikva, Israel, 49100.
The Cochrane Database of Systematic Reviews
|October 29, 2013
Summary
Antibiotics like ciprofloxacin, ceftriaxone, and penicillin are effective for preventing meningococcal disease by eradicating Neisseria meningitidis. Rifampin use may lead to resistant strains, warranting careful consideration.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Meningococcal disease, caused by Neisseria meningitidis, poses a significant risk to household contacts.
- Prophylaxis is crucial for close contacts and populations with high carriage rates of meningococcal infection.
Purpose of the Study:
- To evaluate the effectiveness of various antibiotics in preventing meningococcal infection.
- To assess adverse events and the development of antibiotic resistance associated with prophylactic treatments.
- To determine the efficacy of different antibiotic regimens in eradicating Neisseria meningitidis.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) and quasi-RCTs.
- Searched multiple databases including CENTRAL, MEDLINE, EMBASE, and LILACS.
- Data extraction and analysis using risk ratios (RR) and 95% confidence intervals (CI).
Main Results:
- Ciprofloxacin, rifampin, minocycline, and penicillin demonstrated effectiveness in eradicating Neisseria meningitidis one week post-treatment.
- Rifampin, ciprofloxacin, and penicillin remained effective at one to two weeks.
- Rifampin use was associated with the emergence of resistant isolates; it was also less effective than ceftriaxone.
Conclusions:
- Ciprofloxacin, ceftriaxone, and penicillin are recommended for meningococcal prophylaxis.
- Rifampin use during outbreaks may contribute to the circulation of resistant Neisseria meningitidis strains.
- Further trials are needed to compare the long-term effectiveness of these antibiotics for eradication.
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