Chemoprophylaxis for the prevention of bacterial meningitis

Close contacts of index patients with Neisseria meningitidis or Haemophilus influenzae type b meningitis show higher nasopharyngeal carriage rates and are at an increased risk of contracting the disease. The key issue in the management of such contacts remains close and careful surveillance, because prophylaxis will never result in the absolute prevention of secondary cases. Adequate chemoprophylaxis with rifampin eradicates nasopharyngeal colonization in more than 90% and may prevent both co-primary and secondary diseases. Routine chemoprophylaxis for close contacts of systemic meningococcal diseases is recommended. However, there are several factors inherent in rifampin prophylaxis for the prevention of H. influenzae type b meningitis which exclude its use as a routine measure.