minocycline and Meningitis--Meningococcal

Topics: Anti-Infective Agents; Child; Child, Preschool; Humans; Leucomycins; Meningitis, Haemophilus; Meningitis, Meningococcal; Minocycline; Rifampin; Risk; Sulfonamides

Topics: Ampicillin; Bacterial Infections; Brain Edema; Child, Preschool; Chloramphenicol; Cloxacillin; Gentamicins; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Injections, Spinal; Meningitis; Meningitis, Haemophilus; Meningitis, Meningococcal; Meningitis, Pneumococcal; Methicillin; Minocycline; Neisseria meningitidis; Penicillin G; Rifampin; Seizures; Shock; Streptococcus pneumoniae; Sulfonamides

Topics: Adolescent; Adult; Age Factors; Carrier State; Child; Child, Preschool; Disease Outbreaks; Female; Humans; Infant; Male; Meningitis, Meningococcal; Minocycline; Neisseria meningitidis; Penicillins; Rifampin; Seasons; Serotyping; Sex Factors; Sulfonamides; Vaccination

A high rate of side effects (mostly vestibular) was found among 83 people receiving prophylaxis with minocycline because of contact with a patient who had died of meningitis due to Neisseria meningitidis. Three groups of contacts received different lots of minocycline and different dosage regimens. Seventy-eight percent of these people had symptoms temporally related to ingestion of minocycline. These symptoms, which included dizziness, nausea, vomiting, vertigo, anorexia, and headache, generally commenced soon after initiation of chemoprophylaxis; the total dosage of minocycline was low. The high rate of vestibular side effects of minocycline militates against widespread use of minocycline for prophylaxis of meningococcal infection.

Topics: Adult; Anorexia; Clinical Trials as Topic; Female; Headache; Humans; Meningitis, Meningococcal; Minocycline; Nausea; Neisseria meningitidis; Tetracyclines; Vertigo; Vestibule, Labyrinth; Vomiting

Determination of the major serogroups is an important step for establishing a vaccine programme and management strategy targeting Neisseria meningitidis. From April 2010 to November 2016, a total of 25 N. meningitidis isolates were collected in South Korea, in collaboration with the Korean Society of Clinical Microbiology. Among isolates, 19 isolates were recovered from blood and/or cerebrospinal fluid (CSF) in 46 patients who suffered from invasive meningococcal disease (IMD), and six isolates were found in sputum or the throat. The most common serogroup was serogroup B (overall, 36%, n = 9/25; IMD, 37%, n = 7/19), which was isolated in every year of the research period except for 2011. There were five serogroup W isolates recovered from patients in military service. W was no longer isolated after initiation of a vaccine programme for military trainees, but serogroup B caused meningitis in an army recruit training centre in 2015. In MLST analysis, 14 sequence types were found, and all isolates belonging to W showed the same molecular epidemiologic characteristics (W:P1.5-1, 2-2:F3-9:ST-8912). All isolates showed susceptibility to ceftriaxone, meropenem, ciprofloxacin, minocycline, and rifampin; however, the susceptibility rates to penicillin and ampicillin for isolates with W and C capsules were 22% and 30%, respectively.

Topics: Adolescent; Adult; Aged; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Drug Resistance, Bacterial; Female; Humans; Infant; Male; Meningitis, Meningococcal; Meningococcal Infections; Meropenem; Microbial Sensitivity Tests; Middle Aged; Minocycline; Multilocus Sequence Typing; Neisseria meningitidis; Neisseria meningitidis, Serogroup B; Neisseriaceae Infections; Prevalence; Republic of Korea; Rifampin; RNA, Ribosomal, 16S; Serogroup

To assess the secondary attack rate (SAR) of meningococcal disease among the household contacts of primary patients and to describe the use of chemoprophylaxis in the Netherlands.. Descriptive, nation-wide survey.. Information was collected of patients with meningococcal disease, reported between April 1st, 1989 and April 30th, 1990, and their household contacts. A household contact suffering from meningococcal disease between 24 hours and 1 month after hospital admission of the primary patient, was considered to be a secondary case. Chemoprophylaxis was considered appropriate if rifampicin or minocycline had been prescribed to all household contacts within a maximum of one day after admission of the primary patient.. There were 5 secondary cases (SAR: 0.3%). Chemoprophylaxis was prescribed to 627 of 1130 household contacts (55%). Of those the prophylaxis was considered appropriate in 46%. 2 secondary cases were not given any prophylaxis, 2 received penicillin and 1 rifampicin. Of the primary patients, 6% were given prophylaxis during their hospital stay. All meningococci, isolated from pairs of secondary and primary patients, were rifampicin sensitive.. The SAR of meningococcal disease in the Netherlands is similar to that in other countries. Although prescription of chemoprophylaxis is not recommended by the government, it is prescribed to 55% of the household contacts, and in almost half of these instances it was considered to be appropriate. Chemoprophylaxis is rarely prescribed to primary patients. Recommendations concerning chemoprophylaxis in the Netherlands are in need of reappraisal. Based on the results from this study and the literature, the prescription of chemoprophylaxis to all household contacts of a patient with meningococcal disease, and to the index patient, is recommended.

Topics: Adult; Child; Family; Female; Humans; Male; Meningitis, Meningococcal; Minocycline; Rifampin; Time Factors

A fatal meningitis due to a spiramycin-sensitive group B Neisseria meningitidis occurred 13 days after interruption of a prophylactic antimicrobial therapy with spiramycin. The efficacy of recommended antimicrobial preventive treatment is discussed with regard to this case, other published cases and to the known partial and short term eradication of the naso-pharyngeal carriage of Neisseria meningitidis.

Topics: Adult; Female; Humans; Leucomycins; Meningitis, Meningococcal; Minocycline; Rifampin

Topics: Bacterial Vaccines; Carrier State; Drug Resistance, Microbial; Humans; Meningitis, Meningococcal; Meningococcal Vaccines; Minocycline; Neisseria meningitidis; Nigeria; Rifampin; Sulfadiazine; United States

Close contact of patients with bacterial meningitis that is caused by either Haemophilus influenzae type b or Neisseria meningitidis are at an increased risk of developing invasive infections with these bacteria. Chemoprophylaxis with rifampin and immunoprophylaxis with vaccines may prevent some secondary infections.

Topics: Antibody Formation; Child; Child, Preschool; Humans; Immunization; Infant; Infant, Newborn; Meningitis, Haemophilus; Meningitis, Meningococcal; Minocycline; Rifampin; Risk

Community chemoprophylaxis with a regimen of sequential minocycline/rifampin (adults) or rifampin alone (children [less than 12 years of age]) was undertaken in a remote Arctic community one year after an outbreak of meningitis due to Neisseria meningitidis serogroup B. Nasopharyngeal carriage rates of N. meningitidis before prophylaxis were 32.4% in Inuit (Eskimos) and 6% in Caucasians, with maximal carriage (44.8%) in adolescents. Serogroup B accounted for 63.9% of all isolates before prophylaxis. One week after prophylaxis, the nasopharyngeal carriage rates were 0.8% in Inuit who had received prophylaxis and 33.3% in those who had not received prophylaxis (P less than 0.005). This reduction persisted at nine weeks after prophylaxis, when carriage rates were 1.2% in those who had received prophylaxis and 22.6% in individuals who had not received prophylaxis. Of the strains obtained before prophylaxis, 7.8% were sulfadiazine-resistant, whereas 35% of all isolates obtained from prophylaxis were sulfadiazine-resistant. Rifampin- or minocycline-resistant strains were not identified either before or after prophylaxis.

Topics: Adolescent; Adult; Arctic Regions; Canada; Carrier State; Child; Child, Preschool; Female; Humans; Inuit; Meningitis, Meningococcal; Microbial Sensitivity Tests; Minocycline; Nasopharynx; Neisseria meningitidis; Patient Compliance; Population Surveillance; Pregnancy; Rifampin; Serotyping; Tetracyclines

Two couples of sibs presented with meningococcal meningitis. In both families, immediate preventive measures were not taken due to a negative cerebrospinal fluid (CSF) smear in the first case from Family A, and a negative CSF smear and culture in the first case from Family B. All the children were treated successfully. Our recommendations are: a) contacts of patients with pyogenic meningitis should have close clinical surveillance, and b) contacts of meningococcal infection should have nasopharyngeal cultures and should be given a prophylactic antibiotic such as rifampicin or minocycline.

Topics: Adolescent; Child, Preschool; Female; Humans; Infant; Male; Meningitis, Meningococcal; Minocycline; Rifampin

During an epidemic caused by sulfonamide-resistant group A Neisseria meningitidis (A SuR strain), rifampin (600 mg per day for four days) or minocycline (100 mg every 12 hr for five days) was administered as chemoprophylaxis to 1,540 unvaccinated recruits in the Finnish Armed Forces. Rates of carriage of all strains of N. meningitidis were initially reduced by 78% (from 60% to 13%) in the 389 men receiving rifampin and by 62% (from 70% to 26%) in the 1,151 men receiving minocycline but rose to approximately 30% in both groups four weeks after prophylaxis. The carriage of A SuR strains was similarly reduced. An individual follow-up of 636 trainees demonstrated a high rate of new infections. It is suggested that the long-term inefficiency of rifampin and minocycline is due to their inability to reduce the carriage rates enough to prevent further spread of infection after prophylaxis is descontinued. However, no new cases appeared among the men receiving the prophylaxis. Five strains highly resistant to rifampin were found after the use of rifampin (minimal inhibitory concentration, greater than or equal to 100 microgram/ml), but no minocycline-resistant strains were encountered. No unpleasant side effects were seen in subjects receiving either drug.

Topics: Finland; Humans; Male; Meningitis, Meningococcal; Military Medicine; Minocycline; Neisseria meningitidis; Rifampin; Sulfonamides; Tetracyclines

Meningococcal meningitis as well as meningococcal sepsis must be regarded as complications of an otherwise mild meningococcal infection of the nasopharynx. Only individuals without antibodies against a given meningococcal type will contract the above-mentioned diseases. Causal prophylactic measures have proved to be ineffective because of the great number of "carriers" of meningococci. Immunprophylaxis with specific polysaccharides is effective and presently available for use against types A and C but not against type B. Chemoprophylaxis is most effective when administered to those living in close quarters. Sulfonamides are the prophylaxis of choice agianst meningococci sensitive to sulfonamides. With the appearance of sulfonamide-resistant meningococci, the sulfonamide must be replaced by rifamycin or minocyclin. Though treatment with penicillin gives protection against infection, it does not eradicate the carrier state.

Topics: Adult; Antibodies, Bacterial; Carrier State; Humans; Immunization; Immunization, Secondary; Infant; Meningitis, Meningococcal; Minocycline; Neisseria meningitidis; Penicillin Resistance; Penicillins; Polysaccharides, Bacterial; Rifamycins; Sulfonamides

Minocycline hydrochloride is a tetracycline derivative that has been advocated as the drug of choice in the treatment of meningococcal carriers. Recently, we studied a group of 30 patients who experienced a large number of side-effects after receiving minocycline for treatment of meningococcal meningitis. Twenty-seven of 30 (90%) suffered from dizziness, vertigo, ataxia, weakness, nausea, and vomiting. These symptoms appeared within the first 72 hours of taking minocycline, and disappeared within 48 hours of stopping the medication.

Topics: Adult; Ataxia; Child; Female; Humans; Male; Meningitis, Meningococcal; Minocycline; Nausea; Tetracyclines; Vertigo; Vomiting

Topics: Humans; Male; Meningitis, Meningococcal; Meningococcal Infections; Middle Aged; Minocycline; Rifampin; Sepsis

Topics: Age Factors; Anti-Bacterial Agents; Carrier State; Child; Child, Preschool; Drug Therapy, Combination; Humans; Immunotherapy; Infant; Meningitis, Meningococcal; Meningococcal Infections; Minocycline; Neisseria meningitidis; Penicillin G; Penicillin Resistance; Rifampin; Sulfonamides; United States

Topics: Adult; Child; Humans; Infant; Meningitis, Meningococcal; Minocycline; Neisseria meningitidis; Rifampin

Several recent reports have indicated that minocycline, a drug effective for meningococcal disease prophylaxis, is associated with a high incidence of vestibular side effects. In January 1975, a questionnaire on adverse reactions was completed by all 29 staff members of a North Georgia hospital who had taken minocycline at the recommended dosage after exposure to a suspected meningococcal meningitis case and by 25 age-, sex-, and occupation-matched non-treated controls. In the treated group 86% experienced moderate to severe vestibular symptoms; 84% of the symptomatic persons experienced their onset after one or two doses of 100 mg. Fifty-two percent of the treated staff members stopped taking the medication because of these effects. The symptoms resolved within 48 h after affected persons discontinued the medication. Until the safety of minocycline can be reestablished, rifampin is recommended for meningococcal disease prophylaxis, and alternative drugs are encouraged for other indications.

Topics: Adult; Female; Humans; Male; Meningitis, Meningococcal; Minocycline; Surveys and Questionnaires; Tetracyclines; Vestibule, Labyrinth

Topics: Adolescent; Adult; Drug Hypersensitivity; Female; Humans; Male; Meningitis, Meningococcal; Middle Aged; Minocycline; Tetracyclines

Topics: Antibody Formation; Antigens, Bacterial; Bacterial Vaccines; Carrier State; Disease Outbreaks; Humans; Immunization; Immunotherapy; Meningitis, Meningococcal; Meningococcal Infections; Military Medicine; Minocycline; Neisseria meningitidis; Polysaccharides, Bacterial; Rifampin; Sepsis; Sulfadiazine; United States

An outbreak of meningococcal disease occurred among basic combat trainees at Fort Lewis, Wash., in the first 3 months of 1971. After five recruits developed meningitis within a 2-week period, 8,721 recruits were given 100 mg of minocycline every 12 hr for 5 days. No new cases of meningococcal disease occurred for almost 5 weeks. Then six additional cases occurred among recruits who had entered training after the initial course of minocycline and who had not received the drug. Minocycline was given to all 6,130 of these men, and again occurrence of new cases was halted abruptly. One week later, group C polysaccharide vaccine was administered to all recruits in the first 6 weeks of training and subsequently to all new entering trainees. No new cases of meningitis occurred in the next 3 months. Surveys showed that minocycline significantly lowered the meningococcal carrier rate for 4 to 5 weeks. No strains of Neisseria meningitidis, among 341 isolated after minocycline treatment, were resistant to the drug. Prophylaxis with minocycline clearly interrupted the course of this outbreak due to sulfa-resistant meningococci. Although immunization is the preferred method of prophylaxis, minocycline may be useful until a suitable polyvalent vaccine is available.

Topics: Disease Outbreaks; Humans; Male; Meningitis, Meningococcal; Minocycline; Tetracycline