minocycline and Meningococcal-Infections

Meningococcal disease is a contagious bacterial infection caused by Neisseria meningitidis (N. meningitidis). Household contacts have the highest risk of contracting the disease during the first week of a case being detected. Prophylaxis is considered for close contacts of people with a meningococcal infection and populations with known high carriage rates.. To study the effectiveness, adverse events and development of drug resistance of different antibiotics as prophylactic treatment regimens for meningococcal infection.. We searched CENTRAL 2013, Issue 6, MEDLINE (January 1966 to June week 1, 2013), EMBASE (1980 to June 2013) and LILACS (1982 to June 2013).. Randomised controlled trials (RCTs) or quasi-RCTs addressing the effectiveness of different antibiotics for: (a) prophylaxis against meningococcal disease; (b) eradication of N. meningitidis.. Two review authors independently appraised the quality and extracted data from the included trials. We analysed dichotomous data by calculating the risk ratio (RR) and 95% confidence interval (CI) for each trial.. No new trials were found for inclusion in this update. We included 24 studies; 19 including 2531 randomised participants and five including 4354 cluster-randomised participants. There were no cases of meningococcal disease during follow-up in the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed.Mortality that was reported in one study was not related to meningococcal disease or treatment. Ciprofloxacin (RR 0.04; 95% CI 0.01 to 0.12), rifampin (rifampicin) (RR 0.17; 95% CI 0.13 to 0.24), minocycline (RR 0.28; 95% CI 0.21 to 0.37) and penicillin (RR 0.47; 95% CI 0.24 to 0.94) proved effective at eradicating N. meningitidis one week after treatment when compared with placebo. Rifampin (RR 0.20; 95% CI 0.14 to 0.29), ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) and penicillin (RR 0.63; 95% CI 0.51 to 0.79) still proved effective at one to two weeks. Rifampin was effective compared to placebo up to four weeks after treatment but resistant isolates were seen following prophylactic treatment. No trials evaluated ceftriaxone against placebo but rifampin was less effective than ceftriaxone after one to two weeks of follow-up (RR 5.93; 95% CI 1.22 to 28.68). Mild adverse events associated with treatment were observed.. 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.

Topics: Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Meningococcal disease is a contagious bacterial infection caused by Neisseria meningitidis (N. meningitidis). Household contacts have the highest risk of contracting the disease during the first week of a case being detected. Prophylaxis is considered for close contacts of people with a meningococcal infection and populations with known high carriage rates.. To study the effectiveness of different prophylactic treatment regimens.. We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2011, Issue 2) which contains the Cochrane Acute Respiratory Infections Group Specialised Register, MEDLINE (January 1966 to May Week 3, 2011), EMBASE (1980 to May 2011) and LILACS (1982 to May 2011).. Randomised controlled trials (RCTs) or quasi-RCTs addressing the effectiveness of different antibiotics for: (a) prophylaxis against meningococcal disease; (b) eradication of N. meningitidis.. Two review authors independently appraised the quality and extracted data from the included trials. We analysed dichotomous data by calculating the risk ratio (RR) and 95% confidence interval (CI) for each trial.. We included 24 studies; 19 including 2531 randomised participants and five including 4354 cluster-randomised participants. There were no cases of meningococcal disease during follow up in the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed.Ciprofloxacin (RR 0.04; 95% CI 0.01 to 0.12), rifampin (rifampicin) (RR 0.17; 95% CI 0.13 to 0.24), minocycline (RR 0.28; 95% CI 0.21 to 0.37) and penicillin (RR 0.47; 95% CI 0.24 to 0.94) proved effective at eradicating N. meningitidis one week after treatment when compared with placebo. Rifampin (RR 0.20; 95% CI 0.14 to 0.29), ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) and penicillin (RR 0.63; 95% CI 0.51 to 0.79) still proved effective at one to two weeks. Rifampin was effective compared to placebo up to four weeks after treatment but resistant isolates were seen following prophylactic treatment. No trials evaluated ceftriaxone against placebo but ceftriaxone was more effective than rifampin after one to two weeks of follow up (RR 5.93; 95% CI 1.22 to 28.68). Mild adverse events associated with treatment were observed.. 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.

Topics: Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Meningococcal disease is a contagious bacterial disease caused by Neisseria meningitidis (N. meningitidis). Household contacts have the highest documented risk of the disease during the first seven days of a case being detected. Prophylaxis is, therefore, considered for those in close contact with people with a meningococcal infection and in populations with known high carriage rates as carriers are at increased risk of disease and may pose a risk of infection to others.. To study the effectiveness of different prophylactic treatment regimens in: (1) preventing secondary cases of meningococcal disease after contact with someone with the disease; (2) preventing cases of meningococcal disease in populations with a high rate of N. meningitidis carriers; (3) eradicating N. meningitidis from the pharynx in healthy carriers of N. meningitidis. This review also addresses the issues of adverse effects of prophylaxis and development of drug resistance.. Electronic searches on the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2006), MEDLINE (January 1966 to June 2006), EMBASE (1980 to June 2006), LILACS (1982 to June 2006); and searching of references of all identified studies were performed.. Randomised or quasi-randomised clinical trials addressing the effectiveness of different antibiotic treatments for: (a) prophylaxis against meningococcal disease; (b) eradication of N. meningitidis.. Two reviewers independently appraised the quality of each trial and extracted data from the included trials. Dichotomous data were analysed by calculating the relative risk (RR) and 95% confidence interval for each trial.. There were no cases of meningococcal disease during follow up in any of the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed. Ciprofloxacin (RR 0.04; 95% CI 0.01 to 0.12), rifampin (rifampicin) (RR 0.17; 95% CI 0.12 to 0.24), minocycline (RR 0.30; 95% CI 0.19 to 0.45) and ampicillin (RR 0.41; 95% CI 0.25 to 0.66) proved effective at eradicating N. meningitidis one week after treatment when compared with placebo. However, only rifampin (RR 0.20; 95% CI 0.14 to 0.29) and ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) still proved effective at one to two weeks. Rifampin continued to be effective compared to placebo for up to four weeks after treatment but resistant isolates were seen following prophylactic treatment. No trials evaluated ceftriaxone against placebo but ceftriaxone was more effective than rifampin after one to two weeks of follow up (RR 5.93; 95% CI 1.22 to 28.68).. Given the fact that the use of rifampin in an outbreak setting might lead to the circulation of isolates resistant to rifampin, use of ciprofloxacin or ceftriaxone should be considered. Evidence suggests that all three agents are effective with up to two weeks follow up. Placebo-controlled trials do not seem ethical as prophylactic treatment has been proven to reduce the risk of disease among household contacts. More trials comparing the effectiveness of ceftriaxone, ciprofloxacin and rifampin for eradicating N. meningitidis would provide important insights.

Topics: Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Meningococcal disease is a contagious bacterial disease caused by Neisseria meningitidis (N. meningitidis). The highest documented risk of disease is for household contacts during the first seven days of a case being detected. Prophylaxis is considered for those in close contact with people with a meningococcal infection and in populations with known high carriage rates as carriers are at increased risk of disease and may pose a risk of infection to others.. To study the effectiveness of different prophylactic treatment regimens in: (1) preventing secondary cases of meningococcal disease after contact with a case; (2) preventing cases of meningococcal disease in populations with a high rate of N. meningitidis carriers; (3) eradicating N. meningitidis from the pharynx in healthy carriers of N. meningitidis;This review also addresses the issues of adverse affects and development of drug resistance.. Electronic searches on The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2004), MEDLINE (January 1966 to July 2004), EMBASE (1980 to September 2004), LILACS (1982 to July 2004), and searches of references of all identified studies.. Randomised or quasi-randomised clinical trials addressing the effectiveness of different antibiotic treatments for (a) prophylaxis of/against meningococcal disease; (b) eradication of N. meningitidis.. Two reviewers independently appraised the quality of each trial and extracted data from the included trials. Dichotomous data were analysed by calculating the relative risk (RR) and 95% confidence interval for each trial.. There were no cases of meningococcal disease during follow up in any of the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed. Ciprofloxacin (relative risk (RR) 0.04; 95% CI 0.01 to 0.12), rifampin (RR 0.17; 95% CI 0.12 0.24), minocycline (RR = 0.30; 95% CI 0.19 to 0.45) and ampicillin (RR 0.41; 95% CI 0.25 0.66) proved effective at eradicating N. meningitidis one week after treatment, compared with placebo. However, after one to two weeks only rifampin (RR 0.20; 95% CI 0.14 to 0.29) and ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) still proved effective. No trials evaluated ceftriaxone against placebo. Ceftriaxone was more effective than rifampin, after one to two weeks of follow up (RR 5.93; 95% CI 1.22 to 28.68). Rifampin continued to be effective compared to placebo until up to four weeks of post treatment follow up but resistant isolates were seen following prophylactic treatment.. Given the fact that the use of rifampin in an outbreak setting might lead to the circulation of isolates resistant to rifampin, use of ciprofloxacin or ceftriaxone should be considered.Placebo-controlled trials do not seem ethical as prophylactic treatment has been proven to reduce the risk of disease among household contacts. More trials comparing the effectiveness of ceftriaxone, ciprofloxacin and rifampin for eradicating N. meningitidis could provide important insights.

Topics: Ampicillin; Anti-Bacterial Agents; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Topics: Bacterial Vaccines; Carrier State; Humans; Meningococcal Infections; Minocycline; Nasopharynx; Neisseria meningitidis; Rifampin; Risk; Sulfonamides; Vaccination

Minocycline has proved to have a wider spectrum of activity against both aerobic and anaerobic bacteria and has enhanced tissue penetration when compared with its tetracycline congeners. The latter, and possibly the former, can be related to its increased lipophilicity in the physiologic pH range. It appears to be a superior chemoprophylactic agent against sulfonamide-resistant meningococci that do not become minocycline resistant as a result of treatment. The clinical promise of this agent has been dimmed, however, by recent reports of vestibular toxicity manifest in ambulatory patients. Though data on the frequency and severity of these symptoms are in some conflict, minocycline cannot currently be recommended for general clinical use.

Topics: Anaerobiosis; Bacteria; Clinical Trials as Topic; Drug Resistance, Microbial; Gram-Negative Aerobic Bacteria; Humans; Labyrinth Diseases; Meningococcal Infections; Minocycline; Photosensitivity Disorders; Solubility; Staphylococcus aureus; Tetracyclines; Vestibule, Labyrinth

Topics: Aminoglycosides; Anti-Bacterial Agents; Anti-Infective Agents, Urinary; Bacterial Infections; Bacteroides Infections; Cephalosporins; Drug Hypersensitivity; Haemophilus Infections; Humans; Meningococcal Infections; Minocycline; Penicillin Resistance; Penicillins; Streptococcal Infections; Typhoid Fever

Minocycline has proved to have a wider spectrum of activity against both aerobic and anaerobic bacteria and has enhanced tissue penetration when compared with its tetracycline congeners. The latter, and possibly the former, can be related to its increased lipophilicity in the physiologic pH range. It appears to be a superior chemoprophylactic agent against sulfonamide-resistant meningococci that do not become minocycline resistant as a result of treatment. The clinical promise of this agent has been dimmed, however, by recent reports of vestibular toxicity manifest in ambulatory patients. Though data on the frequency and severity of these symptoms are in some conflict, minocycline cannot currently be recommended for general clinical use.

Topics: Anaerobiosis; Bacteria; Clinical Trials as Topic; Drug Resistance, Microbial; Gram-Negative Aerobic Bacteria; Humans; Labyrinth Diseases; Meningococcal Infections; Minocycline; Photosensitivity Disorders; Solubility; Staphylococcus aureus; Tetracyclines; Vestibule, Labyrinth

Topics: Adult; Aged; Bacteriuria; Female; Humans; Labyrinth Diseases; Male; Meningococcal Infections; Middle Aged; Minocycline; Tetracycline; Tetracyclines

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

Topics: Drug Resistance, Microbial; Meningococcal Infections; Minocycline; Molecular Conformation; Staphylococcal Infections; Tetracyclines

Three hundred twenty-six reported cases of meningococcal disease in the United States from November 1973 through March 1974 were investigated. Three household members became ill with meningococcal disease following onset of the initial case in their household. The secondary attack rate was approximately 3/1,000 household members. In 60% of the households, members were given an antimicrobial drug as chemoprophylaxis for meningococcal disease, but only 35% received minocycline hydrochloride or rifampin, the two drugs now available for the eradication of sulfonamide-resistant meningococci from the nasopharynx. Only 26% given chemoprophylaxis received the drug within 24 hours after the patient's hospital admission. Survey results indicate that the secondary attack rate of meningococcal disease may justify the use of chemoprophylaxis, but that frequently in the United States, the drugs given are likely to be ineffective, give too late, or administered to persons who are not at high risk to meningococcal disease.

Topics: Adolescent; Adult; Ampicillin; Anti-Bacterial Agents; Blood; Child; Child, Preschool; Humans; Male; Meningococcal Infections; Minocycline; Neisseria meningitidis; Penicillins; Recurrence; Rifampin; Sulfonamides; Tetracyclines; United States; Urine

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

Topics: Female; Humans; Male; Meningococcal Infections; Minocycline; Personnel, Hospital; Rifampin

Topics: Humans; Meningococcal Infections; Minocycline; Tetracyclines

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

The frequency of healthy carriers of meningococci in Greece in 1973 has been studied by examining 1105 nasopharyngeal swabs from 731 recruits, during the four recruitment periods of this year. The frequency of healthy carriers among inductees within 24 hours from the arrival in the Camp was 38.9%. After a stay of 35 to 40 days in the training Camp the frequency of healthy carriers rose to 66.4%. Among all the soldiers examined, 24.5% were carriers of meningococci of group B, 13.2% of non-typable strains, 8.1% of autoagglutinable strains, 4.1% of meningococci of group A, 3.7% of meningococci of group C and smaller percentages of strains of groups X, Y, Z and of cross-agglutinating strains. The prevalence of carriers of meningococci of groups A and C and of autoagglutinable strains was higher among recruits who have been in the Camp for 35 to 40 days. The prevalence of carriers of the other serogroups was about the same among the inductees and the other recruits. No significant differences were found in the frequency of carriers of each serogroup among soldiers on their arrival, who were permanent residents of urban or rural areas of various parts of the country. No significant seasonal variation was noted in the frequency of carriers of each serogroup. Frequent changes of the group of meningococci harboured were noted among 374 recruits examined upon their arrival, as well as after 35 to 40 days of residence in the training Camp. Among 534 strains of meningococci examined none was resistant to either minocycline or rifampicin. Among 226 strains isolated from inductees, 44.7% were resistant to 1 mug/ml of sulphadiazine, while among 235 strains isolated from recruits after they have been in the Camp for 35 to 40 days, 57.9% were resistant to that sulphonamide.

Topics: Carrier State; Drug Resistance, Microbial; Greece; Humans; Male; Meningococcal Infections; Military Personnel; Minocycline; Nasopharynx; Neisseria meningitidis; Rifampin; Rural Population; Seasons; Serotyping; Sulfadiazine; Tetracyclines; Time Factors; Urban Population

Topics: Humans; Meningococcal Infections; Minocycline; Rifampin; Tetracyclines

Minocycline is a semi-synthetic tetracycline derivative which is well absorbed and distributed in body tissues and is suitable for twice daily administration. It appears to be as generally effective as other tetracyclines and analogues, but also to be effective in infections due to tetracycline-resistant staphylococci. Side-effects are typical of those of other tetracyclines, but minocycline has been associated with a high incidence of vertigo in some studies. On the other hand, minocycline appears to have little or no photosensitising potential. It is not yet clear whether minocycline can be safely used in patients with moderate or severe impairment of renal function, but if used in renal failure, the plasma urea concentration should be monitored.

Topics: Bacteria; Candida; Cholera; Humans; Malaria; Meningococcal Infections; Minocycline; Respiratory Tract Infections; Sexually Transmitted Diseases; Skin Diseases, Infectious; Tetracyclines; Urinary Tract Infections

Topics: Disease Outbreaks; Drug Evaluation; Drug Resistance, Microbial; Humans; In Vitro Techniques; London; Meningococcal Infections; Minocycline; Neisseria meningitidis; Rifampin; Sulfonamides

Topics: Adult; Child; Child, Preschool; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Penicillin Resistance; Penicillins; Rifampin; Sulfadiazine; Sulfonamides; United Kingdom

Topics: Adolescent; Animals; Anti-Bacterial Agents; Brazil; Carrier State; Child; Child, Preschool; Disease Outbreaks; Drug Resistance, Microbial; Drug Synergism; Drug Therapy, Combination; Follow-Up Studies; Humans; Infant; Meningococcal Infections; Microbial Sensitivity Tests; Minocycline; Neisseria meningitidis; Rabbits; Rifampin; Sulfadiazine

Topics: Drug Resistance, Microbial; Humans; London; Meningococcal Infections; Minocycline; Rifampin; Sulfonamides

Topics: Adolescent; Adult; Bacteriological Techniques; Carrier State; Florida; Humans; Male; Meningococcal Infections; Minocycline; Nasopharynx; Naval Medicine; Neisseria meningitidis; Rifampin; Tetracycline

Topics: Carrier State; Drug Resistance, Microbial; Humans; Male; Meningococcal Infections; Microbial Sensitivity Tests; Military Medicine; Minocycline; Mutation; Nasopharyngeal Diseases; Neisseria meningitidis; Rifampin; Tetracycline

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

Topics: Amino Sugars; Anti-Bacterial Agents; Bacteria; Candidiasis; Carbenicillin; Cephalosporins; Cryptococcosis; Drug Synergism; Flucytosine; Glycosides; Gonorrhea; Humans; Meningococcal Infections; Minocycline; Pseudomonas Infections; Spectinomycin; Sulfonamides; Tetracycline; Trimethoprim