Antibiotic prophylaxis for bacterial meningitis: overuse and uncertain efficacy.
BACKGROUND
There is little evidence supporting the efficacy of prophylactic antibiotics in preventing secondary cases of bacterial meningitis, and recent guidance extended the use of prophylactic antibiotics amongst children who attend pre-school groups.


METHODS
We examined the volume of rifampicin prescribed, and that recommended to contacts of cases of meningococcal and Hib meningitis in Somerset over a three-year period using case note records of the Consultant for Communicable Disease Control (CCDC) and PACT data.


RESULTS
There was evidence of excessive prescribing over and above that recommended by the CCDC.


CONCLUSIONS
Excessive prescribing increases the chance of serious drug side effects and the development of antibiotic resistance. It is suggested that both meningitis contacts and information about early symptoms of meningitis, as well as an explanation of the rationale behind the prescribing of antibiotic prophylaxis to contacts. This may reduce the likelihood of unnecessary prescribing and subsequent complications.
Pearson
N
N
Somerset Health Authority.
Gunnell
D J
DJ
Dunn
C
C
Beswick
T
T
Hill
A
A
Ley
B
B
D000328:Adult; D019072:Antibiotic Prophylaxis; D002648:Child; D002656:Child Day Care Centers; D002675:Child, Preschool; D016358:Contact Tracing; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004363:Drug Utilization; D004739:England; D005194:Family Practice; D005260:Female; D006300:Health Services Misuse; D006801:Humans; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000517:prevention & control* / Q000635:transmission; D008583:Meningitis, Haemophilus / Q000517:prevention & control / Q000635:transmission; D008585:Meningitis, Meningococcal / Q000517:prevention & control / Q000635:transmission; D012293:Rifampin / Q000627:therapeutic use; D012306:Risk; D016896:Treatment Outcome
D012293:Rifampin