ANTIBIOTIC-PROPHYLAXIS FOR BACTERIAL-MENINGITIS - OVERUSE AND UNCERTAIN EFFICACY

Background There is little evidence supporting the efficacy of prophyl actic antibiotics in preventing secondary cases of bacterial meningiti s, and recent guidance extended the use of prophylactic antibiotics am ongst children who attend pre-school groups. Methods We examined the v olume of rifampicin prescribed, and that recommended to contacts of ca ses of meningo coccal and Hib meningitis in Somerset over a three-year period using case note records of the Consultant for Communicable Dis ease Control (CCDC) and PACT data. Results There was evidence of exces sive prescribing over and above that recommended by the CCDC. Conclusi on Excessive prescribing increases the chance of serious drug side eff ects and the development of antibiotic resistance. It is suggested tha t both meningitis contacts and local general practitioners should be g iven adequate information about early symptoms of meningitis, as well as an explanation of the rationale behind the prescribing of antibioti c prophylaxis to contacts. This may reduce the likelihood of unnecessa ry prescribing and subsequent complications.