Clearance antibiotics for close contacts of meningococcal disease

This page has information about clearance antibiotics if you have been a close contact of someone with meningococcal disease.

Around 5 to 10% of the population carry meningococcal bacteria in their nose and throat at any given time, but very few people become unwell as a result.

Meningococcal bacteria only survive in humans and are transmitted from person to person through contact with respiratory secretions.

About clearance antibiotics

Some antibiotics are used to clear the meningococcal bacteria from the nose and throat and prevent the spread to other people. ;Antibiotics normally work in about 24 hours.

These are:

• rifampicin
• ciprofloxacin
• ceftriaxone.

Clearance antibiotics do not treat the infection once it has started to invade the body. People who are ill with meningococcal disease need to be in hospital and treated with appropriate antibiotics.

All antibiotics have a small risk of side effects. Those who need antibiotics are asked about other medicines they are taking, their allergies and if they are pregnant or breastfeeding.

It is important to read and understand the separate information sheet about the antibiotic that has been prescribed for you.

The clearance antibiotics are not a treatment for meningococcal disease, so it is important for you to see a doctor urgently if you get symptoms.

What is a close contact

A close contact is a person who has had close contact with the person with meningococcal  disease in the 7 days before they became ill, or those in very close contact after the onset of the cases symptoms.

This could be because they:

• lived or stayed overnight in the same house
• intimately kissed (deep mouth kissing)
• attended the same childcare centre class as them
• are a health care worker who was directly exposed to the patient’s respiratory secretions via mouth-to-mouth resuscitation or intubation.

If you are a close contact

You should:

• Watch out for symptoms of meningococcal disease and see a doctor urgently if any symptoms develop.
• Take clearance antibiotics as they have been prescribed.
• Tell your close contacts to watch out for symptoms of meningococcal disease and see a doctor urgently if they develop symptoms.

Find out more about meningococcal disease.

Immunisation

There are vaccines which protect against some types of meningococcal disease.

Laboratory tests usually take a few days to determine the type of meningococcus that caused the illness in your close contact. If it is found to be a type that can be covered by a vaccine, the Communicable Disease Control (CDC) Section staff will contact you to recommend a meningococcal vaccine.

Remain vigilant in looking for the signs and symptoms of meningococcal disease even if you have previously been vaccinated. This is because vaccination against one type of meningococcus bacteria will not protect you from the other types.

Ciprofloxacin

Before you take ciprofloxacin, tell your treating health professional if you are taking any medications (including herbal and over-the-counter products) or have any medical conditions. Ciprofloxacin does not interfere with the oral contraceptive pill.

How it's taken

Ciprofloxacin comes in tablet form which can be taken by adults and children 5 years of age and older. The dose dependant on age. It is taken as a single dose by mouth with a full glass of water.

It is best absorbed if you take it 1 hour before, or 2 hours after meals. It is important to drink plenty of fluids for the rest of the day after taking this antibiotic.

Side effects

All medications have side effects. For a full list of side effects, ask your health provider for a copy of the ciprofloxacin consumer medicine information document.

Ciprofloxacin is usually well-tolerated. Common side effects include tiredness or mild stomach ache, but these effects usually settle quickly and are not cause for concern.

Ciprofloxacin can be safely taken if you are breastfeeding but it may cause diarrhoea in the infant.

A very uncommon side effect is allergic reaction to ciprofloxacin (for example, facial swelling, breathing difficulties, or rash).

If at any time you feel unwell after taking this medication, you should seek immediate medical attention.

Who should not take ciprofloxacin

Ciprofloxacin is not recommended for people who:

• are pregnant
• are taking certain medications (talk to your treating health professional)
• had a previous allergic reaction to ciprofloxacin
• have taken antacid or indigestion medications or medications that contain iron or mineral supplements within the previous 4 hours.

Rifampicin

Before you start taking rifampicin, it is important to tell your treating health professional and pharmacist if you are taking any medications.

This includes herbal and over-the-counter products such as antacids and prescribed medications.

For example:

• anticoagulants such as warfarin
• steroids
• several medicines for heart disease
• medicines to control diabetes
• medicines for epilepsy or asthma
• methadone
• antiviral medicine
• antidepressants
• cyclosporin.

Side effects

Common side effects of rifampicin include:

• Orange colouration of urine, tears, saliva and sweat, which is harmless and stops when the medication is discontinued – Rifampicin can permanently stain soft contact lenses so they should not be used during treatment.
• Headache, dizziness or drowsiness.
• Gastrointestinal disturbance, such as nausea and vomiting.
• A very uncommon side effect is allergic reaction to rifampicin, for example, facial swelling, breathing difficulties, or rash. If this occurs, you should seek immediate medical attention.

Who should not take rifampicin

Rifampicin should not be taken by people who:

• are pregnant
• have jaundice or severe liver disease
• are taking certain medications (talk to your health professional)
• have a known allergy to rifampicin.