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October 13, 1975

Meningococcal Prophylaxis

Author Affiliations

University of Colorado Medical Center Denver

JAMA. 1975;234(2):150-151. doi:10.1001/jama.1975.03260150020005

To the Editor.—  In his recent COMMENTARY (231:1035, 1975), Dr Artenstein has defined the dilemma confronting clinicians in protecting family contacts of a patient with meningococcal disease against their documented increased risk of secondary cases.1 I am disturbed, however, by the resolution he has proposed, which states simply that family contacts of patients whose illness is known to be due to sulfonamide-susceptible meningococci be given sulfonamide chemoprophylaxis. Family contacts of patients whose illness is known to be caused by sulfonamide-resistant organisms or in which the sulfonamide resistance of the infecting strain is not known should not be given chemoprophylaxis, but, rather, observed closely, hospitalized, and treated at the first sign of an illness consistent with meningococcemia or meningococcal meningitis.Two new agents, minocycline and rifampin, have proved effective in eliminating meningococci from the nasopharynx of asymptomatic carriers, and it is appropriate to examine each of these more closely. Minocycline