Meningococcal infections treatment

Neisseria meningitidis carriers Treatment of asymptomatic carriers of N. meningitidis to eliminate meningococci from the nasopharynx. Not indicated for treatment of meningococcal infection. 

Ampicillin is essentially equivalent to benzylpenicillin for pneumococcal, streptococcal, and meningococcal infections, and many strains of Gram-negative Salmonella, Shigella, Proteus mirabllls, and Escherichia coll, as well as many strains of Haemophilus influenzae and Neisseria gonorrhoeae, respond well to oral treatment with ampicillin. 

QHgNiOiS. Colourless crystals, m.p. 164 5-166-5" C. It is usually prepared by treating p-acetamidobenzenesulphonyl chloride with ammonia, and hydrolysing the acetyl derivative to the base. Used for the treatment of streptococcal infections, gonorrhoea, meningococcal meningitis and urinary infections. Liable to cause unpleasant reactions, such as nausea, cyanosis and skin rashes. 

From a clinical point of view, the sulphonamides are extremely useful for the treatment of uncomplicated urinary tract infection caused by E. coli in domiciliary practice. They have also been employed in treating meningococcal meningitis (a current... 

Penicillin is the dmg of choice for the treatment of group B streptococcal, meningococcal and pneumococcal infections but, as discussed earlier, CSF concentrations of penicillin are significantly influenced by the intensity of the inflammatoiy response. To achieve therapeutic concentrations within the CSF, high dosages are required, and in the case of pneumococcal meningitis should be continued for 10-14 days. 

Because of potential toxicity, bacterial resistance, and the availability of many other effective alternatives, chloramphenicol is rarely used. It may be considered for treatment of serious rickettsial infections such as typhus and Rocky Mountain spotted fever. It is an alternative to a B-lactam antibiotic for treatment of meningococcal meningitis occurring in patients who have major hypersensitivity reactions to penicillin or bacterial meningitis caused by penicillin-resistant strains of pneumococci. The dosage is 50-100 mg/kg/d in four divided doses. 

Rifampin is used in a variety of other clinical situations. An oral dosage of 600 mg twice daily for 2 days can eliminate meningococcal carriage. Rifampin, 20 mg/kg/d for 4 days, is used as prophylaxis in contacts of children with Haemophilus influenzae type b disease. Rifampin combined with a second agent is used to eradicate staphylococcal carriage. Rifampin combination therapy is also indicated for treatment of serious staphylococcal infections such as osteomyelitis and prosthetic valve endocarditis. Rifampin has been recommended also for use in combination with ceftriaxone or vancomycin in treatment of meningitis caused by highly penicillin-resistant strains of pneumococci. 

C. Clinical Uses Because of its toxicity, chloramphenicol has very few uses as a systemic drug. It is a backup drug for severe infections caused by salmonella and for the treatment of pneumococcal and meningococcal meningitis in beta-lactam-sensitive persons. Some H influenzae strains are... 

Resistance emerges rapidly when rifampin is used as a single agent in the treatment of bacterial infections. It is an effective prophylactic and is used as a back-up drug to INH to prevent tuberculosis. However, when rifampin is used to treat the meningococcal carrier state, up to 10% of treated carriers may harbor rifampin-resistant organisms. The answer is (D). 

Quinolone Antibacterial Agents - Nalidixic acid (I) suspension has been successful in the treatment of urinary tract infections in children and intravenous use has been recommended for urogenital sepsis . Several cases of photosensitization due to I have been reported . A comparison between I and oxolinic acid II in 40 meningococcal strains indicated an... 

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