Meningococcal disease
Parenteral antibiotics should be given at the earliest opportunity, either in primary or secondary care, but urgent transfer to hospital should not be delayed in order to give the parenteral antibiotic.
Intramuscular or intravenous 1.2g
Intramuscular or intravenous 1g
Prescribing Notes:
- If meningococcal disease is suspected, general practitioners should give a single dose of benzylpenicillin or cefotaxime before urgent transfer to hospital. The only contra-indication is a history of true penicillin anaphylaxis; in this case, giving penicillin or an alternative antibiotic may carry increased risk of anaphylactic reactions, and urgent transfer to hospital is the most important measure. Patients with mild allergy (i.e. rash, not anaphylaxis) may receive cefotaxime.
- Public Health should be notified to arrange antibiotic prophylaxis for close (household and kissing) contacts of meningococcal disease.
- For further information including advice on vaccination of the index case and close contacts refer to Public Health England guidance - Meningococcal disease: guidance on public health management.
History Notes
15/12/2021
East Region Formulary content agreed.
Public Health should always be contacted in the first instance.
500mg given immediately
Prescribing Notes:
- Ciprofloxacin chemoprophylaxis for contacts is recommended for all ages and in pregnancy.
- Refer to important safety information for all quinolones prior to prescribing.
- Where an individual is at risk of potential side-effects from ciprofloxacin discuss risk versus benefit and possible alternative options with Public Health.
- Public Health should be notified to arrange antibiotic prophylaxis for close (household and kissing) contacts of meningococcal disease.
- For further information including advice on vaccination of the index case and close contacts refer to Public Health England guidance - Meningococcal disease: guidance on public health management.
History Notes
15/12/2021
East Region Formulary content agreed.
Parenteral antibiotics should be given at the earliest opportunity, either in primary or secondary care, but urgent transfer to hospital should not be delayed in order to give the parenteral antibiotic.
Preferably IV; IM if IV access is difficult.
Neonate
50mg/kg for 1 dose.
Child 1 month-15 years
50mg/kg (max. per dose 2g) for 1 dose, intramuscular doses over 1g should be divided between more than one site.
Child 16-17 years
2g for 1 dose, intramuscular doses over 1g should be divided between more than one site.
Preferably IV; IM if IV access is difficult.
Neonate
50mg/kg for 1 dose.
Child 1 month-15 years
50mg/kg (max. per dose 2g) for 1 dose, intramuscular doses over 1g should be divided between more than one site.
Child 16-17 years
2g for 1 dose, intramuscular doses over 1g should be divided between more than one site.
Prescribing Notes:
- If meningococcal disease is suspected, general practitioners should give a single dose of cefotaxime before urgent transfer to hospital. The only contra-indication is a history of true penicillin anaphylaxis; in this case, giving penicillin or an alternative antibiotic may carry increased risk of anaphylactic reactions, and urgent transfer to hospital is the most important measure. Patients with mild allergy (i.e. rash, not anaphylaxis) may receive cefotaxime.
- NICE recommends that children and young people with suspected bacterial meningitis without non-blanching rash should be transferred directly to secondary care without giving parenteral antibiotics. If urgent transfer to hospital is not possible, for example, in remote locations or adverse weather conditions, antibiotics should be administered to children and young people with suspected bacterial meningitis.
- Refer to the local board antimicrobial guidelines for children for ongoing management.
- For further information including advice on vaccination of the index case and close contacts refer to Public Health England guidance on public health management of Meningococcal disease.
- Public Health should be notified to arrange antibiotic prophylaxis for close (household and kissing) contacts of meningococcal disease.
History Notes
14/03/2024
Prescribing information updated, ERFC March 2024
15/01/2024
East Region Formulary content agreed.
Public Health should always be contacted in the first instance.
Birth to 4 years, 30mg/kg (max 125mg) for 1 dose.
5-11 years, 250mg for 1 dose.
>12 years, 500mg for 1 dose.
Birth to 4 years, 30mg/kg (max 125mg) for 1 dose.
5-11 years, 250mg for 1 dose.
>12 years, 500mg for 1 dose.
Birth to 4 years, 30mg/kg (max 125mg) for 1 dose.
5-11 years, 250mg for 1 dose.
>12 years, 500mg for 1 dose.
Prescribing Notes:
- Public Health should be notified to arrange antibiotic prophylaxis for close (household and kissing) contacts of meningococcal disease.
- Ciprofloxacin chemoprophylaxis for contacts is recommended for all ages and in pregnancy.
- For further information including advice on vaccination of the index case and close contacts refer to Public Health England guidance on public health management of Meningococcal disease.
- Refer to BNF important safety information for all quinolones prior to prescribing.
- Where an individual is at risk of potential side-effects from ciprofloxacin discuss risk versus benefit and possible alternative options with Public Health.
History Notes
15/01/2024
East Region Formulary content agreed.