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ARTICLE |

Meningococcal Prophylaxis FREE

Theodore C. Eickhoff, MD
JAMA. 1975;234(2):150-151. doi:10.1001/jama.1975.03260150020005
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To the Editor.—  In his recent COMMENTARY (231:1035, 1975), Dr Artenstein has defined the dilemma confronting clinicians in protecting family contacts of a patient with meningococcal disease against their documented increased risk of secondary cases.1 I am disturbed, however, by the resolution he has proposed, which states simply that family contacts of patients whose illness is known to be due to sulfonamide-susceptible meningococci be given sulfonamide chemoprophylaxis. Family contacts of patients whose illness is known to be caused by sulfonamide-resistant organisms or in which the sulfonamide resistance of the infecting strain is not known should not be given chemoprophylaxis, but, rather, observed closely, hospitalized, and treated at the first sign of an illness consistent with meningococcemia or meningococcal meningitis.Two new agents, minocycline and rifampin, have proved effective in eliminating meningococci from the nasopharynx of asymptomatic carriers, and it is appropriate to examine each of these more closely. Minocycline

REFERENCES

Munford RS, Taunay AE, Morais JS, et al:  Spread of meningococcal infection within households . Lancet 1:1275-1277, 1974;.
Guttler RB, Counts GW, Avent CK, et al:  Effect of rifampin and minocycline on meningococcal carrier rates . J Infect Dis 124:199-205, 1971;.
Devine LF, Johnson DP, Hagerman CR, et al:  The effect of minocycline on meningococcal nasopharyngeal carrier state in naval personnel . Am J Epidemiol 93:337-345, 1971;.
Munford RS, de Vasconcelos ZJS, Phillips CJ, et al:  Eradication of carriage of Neisseria meningitidis in families: A study in Brazil . J Infect Dis 129:644-649, 1974;.
 Vestibular reactions to minocycline after meningococcal prophylaxis, Center for Disease Control . Morbidity Mortality Weekly Rep 24:9-11, 1975;.
 Vestibular reactions to minocycline: Follow-up, Center for Disease Control Morbidity Mortality Weekly Rep 24:55-56, 1975;.
Eickhoff TC:  In vitro and in vivo studies of resistance to rifampin in meningococci . J Infect Dis 123:414-420, 1971;.
Weidmer CE, Dunkel TB, Pettyjohn FS, et al:  Effectiveness of rifampin in eradicating the meningococcal carrier state in a relatively closed population: Emergence of resistant strains . J Infect Dis 124:172-178, 1971;.
Beam WE, Newberg NR, Devine LF, et al:  The effect of rifampin on the nasopharyngeal carriage of Neisseria meningitidis in a military population . J Infect Dis 124:39-46, 1971;.

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Munford RS, Taunay AE, Morais JS, et al:  Spread of meningococcal infection within households . Lancet 1:1275-1277, 1974;.
Guttler RB, Counts GW, Avent CK, et al:  Effect of rifampin and minocycline on meningococcal carrier rates . J Infect Dis 124:199-205, 1971;.
Devine LF, Johnson DP, Hagerman CR, et al:  The effect of minocycline on meningococcal nasopharyngeal carrier state in naval personnel . Am J Epidemiol 93:337-345, 1971;.
Munford RS, de Vasconcelos ZJS, Phillips CJ, et al:  Eradication of carriage of Neisseria meningitidis in families: A study in Brazil . J Infect Dis 129:644-649, 1974;.
 Vestibular reactions to minocycline after meningococcal prophylaxis, Center for Disease Control . Morbidity Mortality Weekly Rep 24:9-11, 1975;.
 Vestibular reactions to minocycline: Follow-up, Center for Disease Control Morbidity Mortality Weekly Rep 24:55-56, 1975;.
Eickhoff TC:  In vitro and in vivo studies of resistance to rifampin in meningococci . J Infect Dis 123:414-420, 1971;.
Weidmer CE, Dunkel TB, Pettyjohn FS, et al:  Effectiveness of rifampin in eradicating the meningococcal carrier state in a relatively closed population: Emergence of resistant strains . J Infect Dis 124:172-178, 1971;.
Beam WE, Newberg NR, Devine LF, et al:  The effect of rifampin on the nasopharyngeal carriage of Neisseria meningitidis in a military population . J Infect Dis 124:39-46, 1971;.
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