{"id":285,"date":"2009-02-26T10:09:24","date_gmt":"2009-02-26T15:09:24","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=285"},"modified":"2015-06-04T15:31:15","modified_gmt":"2015-06-04T19:31:15","slug":"meningococcal-resistance-to-ciprofloxacin","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/meningococcal-resistance-to-ciprofloxacin\/2009\/02\/26\/","title":{"rendered":"Meningococcal Resistance to Ciprofloxacin"},"content":{"rendered":"<p><a href=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2009\/02\/neisseria_meningitidis11.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-thumbnail wp-image-286\" title=\"neisseria_meningitidis1\" src=\"http:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2009\/02\/neisseria_meningitidis11.jpg\" alt=\"\" width=\"150\" height=\"116\" \/><\/a>Ciprofloxacin-resistant <em>Neisseria<\/em> <em>meningitidis<\/em> has <a href=\"http:\/\/content.nejm.org\/cgi\/content\/short\/360\/9\/886\" target=\"_blank\">now been documented in the United States.<\/a> Here&#8217;s a <a href=\"http:\/\/infectious-diseases.jwatch.org\/cgi\/content\/full\/2009\/225\/1?q=featured_home\" target=\"_blank\">nice summary<\/a> in <em>Journal Watch<\/em>, with two different perspectives.<\/p>\n<p>I suppose we shouldn&#8217;t be surprised, but it did take a while.\u00a0 (At least compared to that other famous neisseria-bug, <em>Neisseria gonorrhoeae<\/em>.)<\/p>\n<p>Oh well.<\/p>\n<p>Why is this important?\u00a0 As every practicing ID doc\/primary care provider\/public health official knows, nothing strikes fear into a community quite like a case of invasive meningococcal disease.\u00a0 Since household contacts of these cases have a many-fold increased risk of developing the disease, preventive therapy is recommended for any close contact &#8212; with &#8220;close&#8221; being defined nicely by one infection-control practitioner I know as &#8220;coughing distance.&#8221;<\/p>\n<p>But we all know that prophylaxis extends way beyond this &#8212; not surprisingly, many more people request and get preventive therapy than actually need it, and in part this is because it&#8217;s so easy to do:\u00a0 a single dose of ciprofloxacin.<\/p>\n<p>Now this needs to be reconsidered.\u00a0 Although it&#8217;s up to each local department of health to determine the recommended preventive therapy, I suspect it won&#8217;t be long before we&#8217;re all back to rifampin (four doses over two days, drug interactions) or a shot of ceftriaxone (ouch).<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ciprofloxacin-resistant Neisseria meningitidis has now been documented in the United States. Here&#8217;s a nice summary in Journal Watch, with two different perspectives. I suppose we shouldn&#8217;t be surprised, but it did take a while.\u00a0 (At least compared to that other famous neisseria-bug, Neisseria gonorrhoeae.) Oh well. Why is this important?\u00a0 As every practicing ID doc\/primary [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,7],"tags":[173,187,271,523,641,751,753,758,801,811],"class_list":["post-285","post","type-post","status-publish","format-standard","hentry","category-infectious-diseases","category-misc","tag-ceftriaxone","tag-ciprofloxacin","tag-department-of-health","tag-invasive-meningococcal-disease","tag-neisseria-meningitidis","tag-preventive-therapy","tag-primary-care","tag-prophylaxis","tag-resistance","tag-rifampin"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/285","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=285"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/285\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=285"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=285"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=285"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}