Close and prolonged contact within 7 days prior to the onset of symptoms until 24 hours after antibiotic treatment including

• Household contacts (highest risk group)
• Childcare contact in same care group (equivalent degree of contact as a household contact)
  • Two full 6-8 hour days
    Or
  • Cumulative 20 hours of contact
• Intimate contacts (kissing)
• Healthcare workers who have unprotected close airway exposure and inadequate PPE
• Passengers sitting immediately adjacent to a case for >8 hours

Ciprofloxacin PO as a single dose

• <5 years: 30 mg/kg (max 125 mg)
• 5-12 years: 250 mg
• ≥12 years: 500 mg

Ceftriaxone is preferred in pregnancy. Rifampicin is preferred in neonates

Rifampicin is contraindicated in pregnancy and severe liver disease

Rifampicin PO BD for 2 days

• <1 month: 5 mg/kg (<1 month)
• ≥1 month: 10 mg/kg (max 600 mg)
• See pharmacological considerations below

Pregnancy or contraindication to Rifampicin:

Ceftriaxone IM as a single dose

• ≥12 years: 250 mg
• 1 month to 12 years: 125 mg

• Prophylaxis must be given early to both the index case and contacts, especially for N. meningitidis disease, because of the rapidity with which secondary cases may develop
• The risk of developing meningococcal disease is highest in the 7-10 days after exposure
• Meningococci are eliminated from the nasopharynx within 24 hours of commencing effective clearance antibiotic therapy
• Vaccination should be offered to non-immunised contacts of cases with N. meningitidis serogroups A, C, W or Y

The index patient if they have not been treated with ceftriaxone/cefotaxime

Close and prolonged contact within 7 days prior to the onset of symptoms until 48 hours after antibiotic treatment including

• Household contacts if the household contains a vulnerable contact (defined below)
• Childcare contacts if they have levels of contact of a household contact, and is a vulnerable contact
• Vulnerable contacts who have shared a hospital room with the index patient
• Healthcare workers who have unprotected close airway exposure and inadequate PPE

The definition of a vulnerable contact is

• an infant <7 months of age (regardless of vaccination status)
• an immunocompromised or asplenic person of any age (regardless of vaccination status)
• Inadequately vaccinated per the following age and contact type
  • Childcare: 7 months - 2 years
  • Household and hospital: 7 months - 5 years

Rifampicin PO daily for 4 days

• <1 month: 10 mg/kg
• ≥1 month: 20 mg/kg (max 600 mg)
• See pharmacological considerations below

Pregnancy or contraindication to Rifampicin

• Ceftriaxone 50 mg/kg (max 1 g) IM daily for 2 days