Chemoprophylaxis for the prevention of meningococcal disease is indicated only for intimate contacts, such as those who eat and sleep in the same dwelling as the index case. Polysaccharide vaccines are effective in preventing infections due to serogroup A and C meningococci in high risk groups such as military recruits and during epidemics. Sulfadiazine remains the chemoprophylactic agent of choice if the index case is known to be serogroup B or Y or sulfonamide susceptible. Rifampin is recommended when the serogroup and antimicrobial susceptibility are unknown. Minocycline may be used as an alternative to rifampin if the dose does not exceed 100 mg/M2/day. Reversible minocycline-induced vestibular toxicity appears to be related to excessive serum concentrations.
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