Evidence-based On-call

Meningitis

Prevention

Use a single dose of ceftriaxone 250mg im ^a

or rifampicin 600mg orally twice daily for 2 days. ^a

Why?

Ceftriaxone is more effective than rifampicin at eradicating nasopharyngeal meningococcus

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
household contacts of confirmed cases of meningococcal meningitis with positive nasal cultures ^a	single dose of im ceftriaxone	oral rifampicin for 2 days	eradication at 6 days	75%	29% (7% to 57%)	5 (3 to 14)
close household contact of patient with confirmed meningococcal meningitis, with nasopharyngeal meningococci ^a	single oral dose of ciprofloxacin 750 mg	oral rifampicin for 2 days	eradication at 2 weeks	97%	-8.0% (-16% to 0.2%)	-13 (-5900 to -6)