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Rifampin and minocycline in meningococcal disease
Reviews of Infectious Diseases
|July 1, 1983
Summary
Minocycline effectively reduced Neisseria meningitidis carriage in military recruits, preventing disease outbreaks. Unlike rifampin, minocycline did not lead to antibiotic resistance, making it a safer choice for meningococcal disease prevention.
Area of Science:
- Microbiology
- Infectious Disease Epidemiology
- Pharmacology
Background:
- Neisseria meningitidis is a significant cause of bacterial meningitis, particularly in close-living populations like military recruits.
- Antibiotic prophylaxis is used to control meningococcal disease outbreaks, but resistance can emerge.
Purpose of the Study:
- To compare the efficacy and resistance patterns of minocycline, rifampin, and ampicillin in reducing Neisseria meningitidis carriage.
- To evaluate the effectiveness of minocycline prophylaxis in controlling an outbreak of meningococcal disease in military recruits.
Main Methods:
- A randomized controlled trial involving four companies of military recruits, administering minocycline, rifampin, ampicillin, or placebo for five days.
- Monitoring of Neisseria meningitidis carriage rates and antibiotic resistance.
- Administration of minocycline to a larger cohort during an outbreak, followed by a second course and vaccination.
Main Results:
- All tested antibiotics reduced Neisseria meningitidis carriage during treatment.
- Minocycline and rifampin demonstrated more prolonged carriage reduction compared to ampicillin and placebo.
- Rifampin-resistant Neisseria meningitidis emerged in 17 recruits, while no minocycline resistance was observed.
- Minocycline prophylaxis halted an outbreak, with a second course and vaccination effectively terminating it.
Conclusions:
- Minocycline is an effective prophylactic agent against Neisseria meningitidis with no observed resistance development.
- Minocycline, combined with vaccination, offers a viable strategy for controlling meningococcal disease outbreaks in high-risk populations.
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