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[Use of josamycin in the eradication of meningococcus]
Abstract:
Because of their in vitro and in vivo activity on Neisseria meningitidis, good salivary and tonsillar tissue levels, high safety and non-penetration through the meningeal barrier, macrolides are agents of choice for treating Meningococcus carriers. To assess the value of josamycin for eliminating Meningococci in carriers, we carried out a 14-month study with bacteriological control. 27 carriers identified (throat specimens) among contacts of 28 children with meningococcal meningitis hospitalized in Pediatrics at the Amiens and Toulouse CHU (teaching hospitals) were treated. Josamycin was given in a dosage of 50 mg/kg/day in children and 2 g/day in adults, in two divided doses daily, for six days. Bacteriologic control at the end of treatment showed that every study patient was free of Meningococci. In vitro, strains recovered from carriers were inhibited by josamycin at concentrations of 0.25 to 1 microgram/l. Given its safety and efficacy, josamycin is well suited to prophylaxis of meningococcal infections.
Insights
Josamycin effectively eliminates Neisseria meningitidis in carriers, demonstrating high safety and efficacy for preventing meningococcal infections. This macrolide antibiotic is a promising option for Meningococcus carrier treatment.
Area of Science:
- Pharmacology and Microbiology
- Infectious Disease Epidemiology
Context:
- Neisseria meningitidis (Meningococcus) poses a public health risk, particularly in carrier states.
- Macrolide antibiotics show promise for treating Meningococcus carriers due to their activity and safety profiles.
Purpose:
- To evaluate the efficacy of josamycin in eradicating Meningococcus from carriers.
- To assess the safety and bacteriological effectiveness of josamycin treatment.
Summary:
- A 14-month study treated 27 Meningococcus carriers (contacts of meningitis patients) with josamycin (50 mg/kg/day for children, 2 g/day for adults) for six days.
- Bacteriological follow-up confirmed complete elimination of Meningococci in all treated individuals.
- In vitro testing showed josamycin inhibited recovered strains at low concentrations (0.25-1 µg/L).
Impact:
- Josamycin demonstrates significant efficacy and safety for treating Meningococcus carriers.
- This finding supports the use of josamycin for prophylaxis against meningococcal infections.
- The study highlights josamycin as a suitable agent for public health interventions targeting Meningococcus transmission.