Eradication of nasopharyngeal carriage of neisseria meningitidis in children and adults in rural africa: A comparison of ciprofloxacin and rifampicin: A comparison of ciprofloxacin and rifampicin

A randomized comparative study ofrifampicin and ciprofloxacin for eradicating nasopharyngeal carriage of meningococci was undertaken in Malawi. Of 1878 contacts of persons with meningococcal meningitis, 1875 were evaluatablefor safety and efficacyofthe drugs. Rifampicin was given to 836 contacts, ciprofloxacin to 711, and ceftriaxone to 328 (children < 2 years old or pregnant or lactating women). One and 2 weeks after therapy, side effects in those given rifampicin and ciproftoxacin were not significantly different. In the ciproftoxacin group, with 470 subjects < 18 years old, only one event (mild abdominal pain) occurred that was related to the drug. Nasopharyngeal carriage was detected in 88 (10.5%) ofthose given rifampicin, 79 (11.1 %) given ciproftoxacin, and 41 (12.5%) given ceftriaxone. Eradication rates after 1 and 2 weeks of treatment, respectively, were 96.5% and 97.7%for rifampicin, 88.6% and 91.1% for ciproftoxacin, and 95.1% and 97.6% for ceftriaxone. Ciproftoxacin provides a safe and effective alternative to rifampicin for eradication of meningococcal carriage in children 2-18 years old.