Rifampicin chemoprophylaxis

Spread of meningococcus between family members and close contacts is well recognised and chemoprophylaxis is recommended for close contacts as soon as possible, preferably within 24 hours. Rifampicin 600 mg every 12 hours for 2 days is licensed for chemoprophylaxis but ciprofloxacin 500 mg orally as a single dose (unlicensed) is also effective and often recommended for convenience. 

It acts by inhibiting RNA synthesis, bacteria being sensitive to this effect at much lower concentrations than mammalian cells it is particularly effective against mycobacteria that lie semidormant within cells. Rifampicin has a wide range of antimicrobial activity. Other uses include leprosy, severe Legionnaires disease (with erythromycin or ciprofloxacin), the chemoprophylaxis of meningococcal meningitis, and severe staphylococcal infection (with flucloxacillin or vancomycin). 

Examples of chemoprophylaxis in the non-surgical arena include the prevention of endocarditis with amoxicillin in patients with valvular heart disease undergoing dental surgery, and the prevention of secondary cases of meningococcal meningitis with rifampicin among household contacts of an index case. 

In a retrospective study in Brazil in 319 patients who underwent liver transplant and survived more than 1 month tuberculosis was identified in five women, mean age 40 years [ST f. None received chemoprophylaxis before or after liver transplant. Two had disseminated tuberculosis, two had pulmonary disease, and one had extrapulmonary disease. Cultures were positive in four. Four patients received isoniazid, rifampicin, and... 

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See also in sourсe #XX -- [ ]

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