FIELD TRIAL OF THE EFFICACY OF A PREVIOUSLY PROPOSED REGIMEN USING MINOCYCLINE AND RIFAMPIN SEQUENTIALLY FOR THE ELIMINATION OF MENINGOCOCCI FROM HEALTHY CARRIERS1

Abstract

Devine, L. F., R. B. Pollard, P. E. Krumpe, E. S. Hoy, R. E. Mammen, C. H. Miller and R. O. Peckinpaugh (Naval Medical Research Unit No. 4, Great Lakes, Ill. 60088.) Field trial of the efficacy of a previously proposed regimen using minocycline and rifampin sequentially for the elimination of meningococci from healthy carriers. Am J Epidemiol 97: 394–401, 1973.—A field trial of a previously proposed regimen of treatment for the elimination of meningococci from the nasopharynges of healthy carriers was conducted in a naval recruit camp. The regimen of treatment for each man consisted of six consecutive doses given at 12-hour intervals in the following sequence: 200, 100 and 100 mg of minocycline given at 0, 12 and 24 hours followed by 600 mg of rifampin given at 36, 48 and 60 hours, respectively. Nasopharyngeal cultures were taken at 24 hours prior to treatment and at 60 to 84 hours after termination of treatment. Twelve per cent of the men were cultured weekly and all men within three days of graduation. There were 3863 men cultured 24 hours prior to treatment who received all doses of the drug and were recultured 60 to 84 hours after treatment. There were 1258 meningococcal carriers prior to treatment and seven carriers after treatment. One of the seven strains isolated 60 to 84 hours after treatment was a rifampin-resistant group Y strain. All seven meningococcal strains were sensitive to minocycline. The rifampin-resistant group Y strains subsequently spread to some of the other treated and untreated men. Six weeks after the last treated men were graduated, no more rifampin-resistant strains were isolated. Minocycline-resistant strains were not isolated at any time before or after treatment. Thirty-five rifampin-resistant strains were isolated from treated and 20 from untreated men within three days of graduation.