Question:medium
What is the drug of choice for mass chemoprophylaxis of meningococcal meningitis?
What is the drug of choice for mass chemoprophylaxis of meningococcal meningitis?
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Rifampicin clears nasopharyngeal carriage - the prophylactic drug of choice.
Updated On: Jun 23, 2026
- Rifampicin
- Chloramphenicol
- Tetracycline
- Penicillin
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The Correct Option is A
Solution and Explanation
Step 1: Target the goal of prophylaxis. After a meningococcal case, close contacts must be cleared of nasopharyngeal carriage. The agent that does this and is the classic answer is rifampicin.
Step 2: Remember the schedule. Rifampicin is dosed by weight - 5 mg/kg for infants below 1 month, 10 mg/kg above - taken orally twice daily for 2 days, and avoided in pregnancy.
Step 3: List backups for special groups. When rifampicin is unsuitable, ceftriaxone given intramuscularly as a single dose (125 mg if under 15, 250 mg if over 15) or a single 500 mg oral dose of ciprofloxacin (adults over 18) can be used.
Step 4: Exclude the wrong drugs. Penicillin treats invasive disease but does not reliably eradicate carriage; chloramphenicol and tetracycline are not first-line prophylaxis here. Hence rifampicin stands.
\[\boxed{\text{Rifampicin}}\]
Step 2: Remember the schedule. Rifampicin is dosed by weight - 5 mg/kg for infants below 1 month, 10 mg/kg above - taken orally twice daily for 2 days, and avoided in pregnancy.
Step 3: List backups for special groups. When rifampicin is unsuitable, ceftriaxone given intramuscularly as a single dose (125 mg if under 15, 250 mg if over 15) or a single 500 mg oral dose of ciprofloxacin (adults over 18) can be used.
Step 4: Exclude the wrong drugs. Penicillin treats invasive disease but does not reliably eradicate carriage; chloramphenicol and tetracycline are not first-line prophylaxis here. Hence rifampicin stands.
\[\boxed{\text{Rifampicin}}\]
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