Azithromycin compared with rifampin for eradication of nasopharyngeal colonization by Neisseria meningitidis

Girgis, Nabil I.; Sultan, Yehia; Frenck, Robert W.; El-Gendy, Atef; Farid, Z.; Mateczun, Alfred

doi:10.1097/00006454-199809000-00013

Cited by 64 publications

(21 citation statements)

References 4 publications

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“…These agents generally decrease nasopharyngeal carriage by 90 to 95%. There is also evidence that azithromycin may be effective in eradicating meningococcal carriage (131,139) but this drug is not a recommended regimen in the United States (28,65). Rifampin-resistant strains are seen commonly with the persistence of meningococcal carriage despite rifampin chemoprophylaxis (160,180,249,353,376).…”

Section: Clinical Aspects Of Meningococcal Infectionmentioning

confidence: 99%

Prospects for Vaccine Prevention of Meningococcal Infection

2006

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SUMMARY Neisseria meningitidis is the leading cause of bacterial meningitis in the United States and worldwide. A serogroup A/C/W-135/Y polysaccharide meningococcal vaccine has been licensed in the United States since 1981 but has not been used universally outside of the military. On 14 January 2005, a polysaccharide conjugate vaccine that covers meningococcal serogroups A, C, W-135, and Y was licensed in the United States for 11- to 55-year-olds and is now recommended for the routine immunization of adolescents and other high-risk groups. This review covers the changing epidemiology of meningococcal disease in the United States, issues related to vaccine prevention, and recommendations on the use of the new vaccine.

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Section: Clinical Aspects Of Meningococcal Infectionmentioning

confidence: 99%

Prospects for Vaccine Prevention of Meningococcal Infection

2006

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“…Rifampicin is currently employed prophylactically to eliminate pharyngeal carriage of Neisseria meningitidis, thereby lowering the potential risk of meningitis [91][92][93]. The selection of resistant Neisseria mutants could theoretically be the consequence of rifaximin use for GI infections.…”

Section: Pharmacology and Clinical Use Of Rifaximinmentioning

confidence: 99%

Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical Potential

2005

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Rifaximin (4-deoxy-4′-methylpyrido[1′,2′-1,2]imidazo- [5,4-c]-rifamycin SV) is a synthetic antibiotic designed to modify the parent compound, rifamycin, in order to achieve low gastrointestinal (GI) absorption while retaining good antibacterial activity. Both experimental and clinical pharmacology clearly show that this compound is a nonsystemic antibiotic with a broad spectrum of antibacterial action covering Gram-positive and Gram-negative organisms, both aerobes and anaerobes. Being virtually nonabsorbed, its bioavailability within the GI tract is rather high with intraluminal and fecal drug concentrations that largely exceed the minimal inhibitory concentration values observed in vitro against a wide range of pathogenic organisms. The GI tract represents, therefore, the primary therapeutic target and GI infections the main indication. The appreciation of the pathogenic role of gut bacteria in several organic and functional GI diseases has increasingly broadened its clinical use, which is now extended to hepatic encephalopathy, small intestine bacterial overgrowth, inflammatory bowel disease and colonic diverticular disease. Potential indications include the irritable bowel syndrome and chronic constipation, Clostridium difficile infection and bowel preparation before colorectal surgery. Because of its antibacterial activity against the microorganism and the lack of strains with primary resistance, some preliminary studies have explored the rifaximin potential for Helicobacter pylori eradication. Oral administration of this drug, by getting rid of enteric bacteria, could also be employed to achieve selective bowel decontamination in acute pancreatitis, liver cirrhosis (thus preventing spontaneous bacterial peritonitis) and nonsteroidal anti-inflammatory drug (NSAID) use (lessening in that way NSAID enteropathy). This antibiotic has, therefore, little value outside the enteric area and this will minimize both antimicrobial resistance and systemic adverse events. Indeed, the drug proved to be safe in all patient populations, including young children. Although rifaximin has stood the test of time, it still attracts the attention of both basic scientists and clinicians. As a matter of fact, with the advancement of the knowledge on microbial-gut interactions in health and disease novel indications and new drug regimens are being explored. Besides widening the clinical use, the research on rifaximin is also focused on the synthesis of new derivatives and on the development of original formulations designed to expand the spectrum of its clinical use.

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“…We found 6 RCTs comparing different antibiotic regimens (table 3). [26][27][28][29][30][31] Two RCTs found no significant difference between rifampin and either minocycline, ciprofloxacin, or intramuscular ceftriax- …”

Section: Benefitsmentioning

confidence: 99%