Download meningoccus chemoprophylaxis

MENINGOCCUS CHEMOPROPHYLAXIS
STANDING ORDERS
INTRODUCTION
The purpose of chemoprophylaxis for individuals who have been in contact with a person who
has developed meningococcal infection is to prevent these individuals from developing
meningococcal infection themselves. This in turn prevents them from spreading the infection
as well.
INDICATIONS
Chemoprophylaxis is appropriate for individuals who have been exposed to a patient who has
meningococcal infection or who were exposed to that person within the 7 days prior to the time
when the patient became symptomatic with meningococcal infection. An exposed person is
defined as one who is a household member, child care center or nursery school participant, or
who has had contact with oral secretions of the case such as sharing food and beverage,
kissing, and handling of soiled facial tissues or other objects.
PROPHYLAXIS NEEDS TO BE INITIATED AS SOON AS POSSIBLE AFTER DIAGNOSIS OF
THE INDEX CASE. IF AT ALL POSSIBLE, IT SHOULD BE STARTED WITHIN 24 HOURS OF
DIAGNOSIS OF THE PRIMARY CASE.
Close surveillance of intimate contacts is important and if symptoms develop, evaluate
immediately for treatment. A letter of explanation is sent to the intimate contacts if the Medical
Director approves it.
CONTRAINDICATIONS
No person should receive a medication to which it is reasonably suspected that they are
allergic. Individuals with reasonable suspicion of liver disease should not receive rifampin until
discussing the case with the medical director. If a person may makes an informed decision
against receiving chemoprophylaxis, they should not receive it.
DRUGS OF CHOICE
When sensitivity of an organism is unknown, the drugs of choice are:
For children less than 18 years old: rifampin
For non-pregnant adults: ciprofloxacin
For pregnant adults: ceftriaxone
Individuals who are allergic to the above drug of choice should receive an alternate effective
drug after consultation with the medical director regarding specific choice of medication.
Meningococcus Chemoprophylaxis Standing Order, Page 1 of 2
DOSAGE AND ADMINISTRATION
Rifampin
Dosage is given every 12 hours for 48 hours - 4 total doses
Children under 1 month old - 5 mg/kg
6.6 lb.
3 kg
15 mg
11 lb.
5 kg
25 mg
22 lb
10 kg
50 mg
Adults and Children over 1 month old - 10 mg/kg
15 lb.
7.5 kg
75 mg
33-49 lbs.
15-22.5 kg
150 mg
50-82 lbs.
22.6-37.5 kg 300 mg
83-115 lbs. 37.6-52.5 kg 450 mg
> 116 lbs.
52.6-60 kg
600 mg
*Rifampin causes urine to turn red, and discolors all body fluids
(remove contact lenses). Must use back-up method if on birth control
pills.
Cipro
Dosage is 500 mg as a single oral dose
Ceftriaxone
For children < 12 years old, use 125 mg IM as a single dose
For children > 12 years old and for adults, use 250 mg IM as a single dose
REFERENCES
American Academy of Pediatrics. Meningococcal Infections. In: Peter G, ed. 1997 Red
Book: Report of the Committee on Infectious Diseases. 24th ed. Elk Grove Village, IL
DISTRIBUTION
Public Health Nurses
Director of Nursing
John R. Spriegel, M.D., M.P.H.
Medical Director
Date
Rev: 9/8/1999
StandingOrders/MeningococcusProphylaxis.doc
Meningococcus Chemoprophylaxis Standing Order, Page 2 of 2