Comparison between bacampicillin and amoxycillin in treating genital and extragenital infection with Neisseria gonorrhoeae and pharyngeal infection with Neisseria meningitidis. Efficacy of rifampin in treatment of meningococcal carriers. Therapeutic trial of cephalexin in meningococcal carriers. Evaluation of single-dose ciprofloxacin in the eradication of Neisseria meningitidis from nasopharyngeal carriers. [Evaluation of the sanative action of rifampicin on the meningococcal carrier state]. Effect of rifampin and minocycline on meningococcal carrier rates. Rifampin. Levels in serum and saliva and effect on the meningococcal carrier state. The effect of coumermycin A on the meningococcal carrier state. Antibiotic prophylaxis of carriers of sulfadiazine-resistant meningococci. Single-dose ceftriaxone to eradicate pharyngeal Neisseria meningitidis. The effect of rifampicin on meningococcal carriage in family contacts in northern Nigeria. Seroepidemiology and chemoprophylaxis disease due to sulfonamide-resistant Neisseria meningitidis in a civillian population. Eradication of carriage of Neisseria meningitidis in families: a study in Brazil. Efficacy of ciprofloxacin in the treatment of nasopharyngeal carriers of Neisseria meningitidis. Eradication of nasopharyngeal carriage of Neisseria meningitidis in children and adults in rural Africa: a comparison of ciprofloxacin and rifampicin. Azithromycin compared with rifampin for eradication of nasopharyngeal colonization by Neisseria meningitidis. The effect of minocycline on meningococcal nasopharyngeal carrier state in naval personnel. Effect of ciprofloxacin on carrier rate of Neisseria meningitidis in army recruits in Finland. Equivalence of ceftriaxone and rifampicin in eliminating nasopharyngeal carriage of serogroup B Neisseria meningitidis. [Efficacy of rifampicin in the treatment of Meningococcus carriers]. Evaluation of Sch 29,482 in the eradication of Neisseria meningitidis from nasopharyngeal carriers.
Sixty three patients presumed to have genital gonorrhoea who gave histories of extragenital sexual practices were randomly treated with amoxycillin 3 g or bacampicillin 4.8 g (equivalent to 3.5 g ampicillin) with probenecid 1 g to compare the efficacy of the drugs in treating gonorrhoea at all sites. Three patients were initially culture negative, and seven failed to return for follow up. Twenty seven of 28 patients receiving bacampicillin and all 25 receiving amoxycillin gave negative genital cultures for Neisseria gonorrhoeae five to nine days after treatment. Twenty two of 60 patients had extragenital gonorrhoea. One failed to return, but all eight who had received amoxycillin and 12 of 13 who had received bacampicillin gave negative pharyngeal and anorectal cultures after treatment. N meningitidis was isolated from the pharynx in 17 of 60 patients on initial attendance. Three of 14 were still colonised with the meningococcus after treatment. Two of 32 patients receiving amoxycillin and 12 of 31 receiving bacampicillin reported experiencing gastrointestinal side effects. nan nan The ability of a single oral 750-mg dose of ciprofloxacin to eradicate Neisseria meningitidis from persistent nasopharyngeal carriers was prospectively evaluated in a placebo-controlled, randomized, double-blinded study. Cultures of specimens taken from all 23 ciprofloxacin-dosed subjects 1 day postdose were negative; cultures from 96% of these subjects were negative at 7 and 21 days postdose, including a specimen from a subject colonized with a minocycline-resistant strain. Of 22 placebo recipients, 20 (91%) remained culture positive. Single-dose ciprofloxacin appears efficacious for meningococcal prophylaxis. The results of the epidemiological control experiment on the efficacy of rifampicin in sanation of meningococci carriers are presented. The preliminary study of rifampicin sensitivity of 41 freshly isolated nasopharyngeal meningococcal strains showed that the MIC of the drug for 63 per cent of the isolates was 0.04--0.1 gamma/ml. Sanation was performed for 2 days; 1.2 g of the drug was used during the treatment course. The results of examination of 91 meningococci carriers showed that 4 days after the sanation the specific weight of the persons isolating no meningococci was reliably higher in the experimental group than that in the control group. The coefficient of rifampicin efficiency was 70.8 per cent. 10 days after sanation the difference in the level of the carriers isolating no meningococci in the experimental and the control groups was statistically insignificant. Therefore, the carriers treated with the drug received temporary protection from the causative agent at an average for 1 week. Later on they could become carriers again. As a result of sanation no changes in the meningococcal sensitivity to rifampicin was observed. nan nan nan nan nan nan nan nan nan A randomized comparative study of rifampicin and ciprofloxacin for eradicating nasopharyngeal carriage of meningococci was undertaken in Malawi. Of 1878 contacts of persons with meningococcal meningitis, 1875 were evaluatable for safety and efficacy of the drugs. Rifampicin was given to 836 contacts, ciprofloxacin to 711, and ceftriaxone to 328 (children < 2 years old or pregnant or lactating women). One and 2 weeks after therapy, side effects in those given rifampicin and ciprofloxacin were not significantly different. In the ciprofloxacin group, with 470 subjects < 18 years old, only one event (mild abdominal pain) occurred that was related to the drug. Nasopharyngeal carriage was detected in 88 (10.5%) of those given rifampicin, 79 (11.1%) given ciprofloxacin, and 41 (12.5%) given ceftriaxone. Eradication rates after 1 and 2 weeks of treatment, respectively, were 96.5% and 97.7% for rifampicin, 88.6% and 91.1% for ciprofloxacin, and 95.1% and 97.6% for ceftriaxone. Ciprofloxacin provides a safe and effective alternative to rifampicin for eradication of meningococcal carriage in children 2-18 years old. To evaluate the efficacy and safety of azithromycin compared with rifampin for eradication of nasopharyngeal carriage of Neisseria meningitidis
                Pharyngeal swabs were obtained from 500 students attending nursing school in Cairo, Egypt, to determine the colonization rate with N. meningitidis. Colonized individuals were randomized to receive azithromycin (500 mg once) or rifampin (600 mg twice daily for four doses). Subjects were then recultured 1 and 2 weeks posttreatment to determine the effectiveness of the antibiotic therapy for eradication of meningococcal nasopharyngeal colonization.
                Individuals treated with azithromycin had a 93% eradication rate at 1 and 2 weeks posttreatment comparable with 95 and 91%, respectively, for rifampin. No significant side effects were reported by any subjects treated with either antibiotic.
                Azithromycin is effective in the eradication of N. meningitidis from the nasopharynx of asymptomatic colonized individuals and deserves further evaluation for use as prophylaxis against N. meningitidis. nan The efficacy of ciprofloxacin in eradicating pharyngeal colonization of Neisseria meningitidis was studied among army recruits in Finland. Ciprofloxacin (250 mg) or placebo was given twice a day for 2 days to 118 meningococcal carriers. Meningococcal carriage was eradicated in 96% of subjects given ciprofloxacin and in 13% of those given placebos. The efficacy of ceftriaxone in eliminating nasopharyngeal carriage of Neisseria meningitidis was compared with that of rifampicin during an epidemic of serogroup B meningococcal disease in Auckland, New Zealand. Household contacts of cases had a throat swab taken and were randomized to treatment. Carriers had a repeat swab taken 6 days later to determine efficacy of treatment. Ceftriaxone (98.2%) was equivalent to rifampicin (97.6%) in eliminating serogroup B N. meningitidis. It is cheaper than rifampicin and has the advantage of full compliance and fewer contraindications, but its acceptability by patients may limit its use as a first-line prophylactic agent. nan Fifty-eight chronic carriers of Neisseria meningitidis were given 250 mg of Sch 29,482 or placebo orally every 6 h for 4 days. Although 22 of 29 subjects taking Sch 29,482 became culture negative while taking the drug, only five were culture negative 2 weeks posttherapy. There were no significant adverse reactions.
Using rifampin during an outbreak may lead to the circulation of resistant isolates. Use of ciprofloxacin, ceftriaxone or penicillin should be considered. All four agents were effective for up to two weeks follow up, though more trials comparing the effectiveness of these agents for eradicating N. meningitidis would provide important insights.