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Antibiotics can prevent meningitis outbreaks

June 03, 2004

Giving antibiotics to everyone living in the same household as a patient who has had meningitis can substantially reduce the risk of further cases, according to a study in this week's BMJ.

Researchers analysed five studies to evaluate the effectiveness of giving chemoprophylaxis (preventive medicine) to the patient and to contacts in households and childcare settings.

They found that the risk of meningococcal disease in household contacts of a patient is reduced by 89% if they take antibiotics that eradicate meningococcal carriage. Another way of expressing this risk reduction across a population is that about 200 household contacts need to be treated to prevent one case during the first month.

The evidence also suggests giving preventive treatment to the patient before discharge from hospital, as at least 3% of patients will still carry the virulent meningococcal strain after treatment with penicillin.

However, there was no evidence to support indiscriminate prescribing of antibiotic prophylaxis to people outside this group, and there were insufficient studies to estimate the effect of chemoprophylaxis in childcare settings.

So far, a lack of evidence has led to different control policies across Europe. This paper reinforces current UK policy and provides sufficient evidence to encourage further consistency, conclude the authors.
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BMJ

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