Single dose ciprofloxacin for the eradication of pharyngeal carriage of Neisseria meningitidis

Abstract

Single dose oral ciprofloxacin was given to all personnel in a naval training establishment as part of the management of an outbreak of meningococcal meningitis. Two thousand one hundred personnel received the drug and Neisseria meningitidis was eradicated from the pharynx of 97% of 570 who were swabbed two to four days later. In a cohort of 277 personnel who were followed for up to nine weeks, pharyngeal carriage was eliminated from 93% of 104 carriers. The overall prevalence of carriage fell from 19% to less than 1.5% as a result of the use of ciprofloxacin. Few side effects were encountered, compliance was good and meningococci resistant to the antibiotic were not found after therapy. A single oral dose of ciprofloxacin 500 mg eliminates pharyngeal carriage of N. meningitidis effectively and has few adverse reactions.

Prospects for Vaccine Prevention of Meningococcal Infection

“…In a study conducted by the Centers for Disease Control and Prevention (CDC), none of 693 household contacts of a meningococcal case who received appropriate chemoprophylaxis developed meningococcal disease, compared with 5 of 1,179 (0.424%) contacts who received no drugs or those felt to be ineffective (236,237). Chemoprophylactic agents that can be used to prevent secondary cases among adult contacts of patients with meningococcal infection include rifampin, single-dose intramuscular ceftriaxone, or single-dose oral ciprofloxacin; the first two agents can also be used in children (65,83,92,130,180,277,284,315,316,325). These agents generally decrease nasopharyngeal carriage by 90 to 95%.…”

Method To Detect Only Live Bacteria during PCR Amplification

“…There have been no reports of the inhibition of PCR products from heat-treated bacteria using DNA gyrase/topoisomerase IV poison (e.g., fluoroquinolones) and/or mammalian topoisomerase poisons (T-poisons). We employed EMA, which cleaves DNA after photoactivation (32), DNA gyrase/topoisomerase IV poison (8,15,24,37), and mammalian topoisomerase (I and II) poisons (3,7,14,18,19,34). We examined whether the DNA of injured/dead bacteria are cleaved by EMA with the aid of ciprofloxacin (CIN) or T-poisons and whether PCR final products from the bacteria could be completely suppressed.…”

Use of single-dose ofloxacin to eradicate tonsillopharyngeal carriage of Neisseria meningitidis

“…Administration of a single dose of ofloxacin to 80 of 84 meningococcal carriers reduced the carrier rate at the college from 21.4 to 3.7%. During the subsequent 6 months, no new case of meningococcal disease was observed in 0ystese.…”

“…Rifampin is considered effective, but it frequently causes side effects (1) and has induced resistance after widespread use (2). Ciprofloxacin has proven highly effective against meningococcal carriage (13,14), even as a single-dose regimen (5,6), and resistant strains have not been isolated. Ofloxacin is highly effective against N. meningitidis in vitro and has favorable pharmacokinetic properties compared with those of ciprofloxacin.…”