Meningococcal disease - antibiotics for close contacts of a person with meningococcal infection: ciprofloxacin, rifampicin

Close contacts of a person with meningococcal disease sometimes develop the disease. Some close contacts are carriers of the meningococcal bacteria and can transmit these bacteria to others who may become ill. To decrease this risk, public health authorities may give antibiotics to close contacts. Close contacts are people who have had close and prolonged contact with a case and are mostly household members, but can include others such as sexual partners.

Background

Only people who were in close contact with a case in the seven days before the person fell ill receive antibiotics. The antibiotics get rid of the bacteria from the throat and nose and help reduce further disease transmission. However, as these antibiotics cannot be used to treat someone who is already developing the disease (different antibiotics are used for treatment), there is still some risk of developing meningococcal disease.

All contacts, whether or not they have received antibiotics or have been vaccinated, need to be alert for any signs and symptoms of the disease for around 2 weeks after their last contact with the infected person. They should seek urgent medical attention if symptoms develop (see the meningococcal disease fact sheet and meningococcal disease symptom chart under Other Resources).

The antibiotics given to very close contacts are usually either ciprofloxacin or rifampicin. Pregnant women may need a different antibiotic (ceftriaxone) given as a single injection.

Ciprofloxacin

You or your child should not take this medicine if you or your child:

• have had a previous allergic reaction to ciprofloxacin
• are pregnant or breast feeding.

It is quite safe to take ciprofloxacin if you are on the birth control pill. It is important that you take the tablet as follows:

• The tablet should be swallowed whole with a full glass of water.
• Do not take the tablet if you have taken antacid/indigestion medicines or medicines containing iron or mineral supplements within the last four hours.

A very uncommon side effect of an allergic reaction with facial swelling, tightness in the throat or breathing difficulty has been reported in about one in 1,000 people following a single dose of ciprofloxacin. This may happen soon after taking the tablet. If this occurs, you should seek medical attention immediately.

Rifampicin

Rifampicin should not be taken by a person who:

• has yellow jaundice (a liver problem)
• is pregnant.

Rifampicin is taken twice a day for two days (a total of four doses). It should be taken on an empty stomach, half an hour before or two hours after food. A few people feel 'off' after taking rifampicin. Stomach upset, headache and dizziness can occur.

Rifampicin can also stain urine and tears a pink-orange colour. This discolouration is harmless and stops when the medication is discontinued. Rifampicin can permanently stain soft contact lenses so use of these during treatment should be avoided.

Interactions with other medicines

If you are taking any prescription drugs, check with your doctor as the dosage of your medication may need adjustment while on rifampicin.

Women taking the contraceptive pill should continue to take it, omitting any pill free interval while taking rifampicin and for the seven days after the last dose of rifampicin. They should also use additional barrier contraception such as condoms or diaphragm while taking rifampicin and for four weeks after the last dose of rifampicin.