The Effect of Rifampin on the Nasopharyngeal Carriage of Neisseria meningitidis in a Military Population

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Abstract
The effect of rifampin on nasopharyngeal carriage of Neisseria meningitidis was studied in a relatively closed population of approximately 1,600 military trainees at a time when the rate of carriage among subpopulations ranged between 43% and 86%. Cultures were taken from volunteers who were immediately started on a drug regimen of 600 mg of rifampin daily for four days; no side reactions were observed. Cultures were taken one and two weeks after treatment, and again when the men left camp. The rate of meningococcal carriage was reduced from 65.1% just before treatment to 10.1% four days after treatment. This was a relative reduction of 84.5 %, with variations between 62.8% and 95.5 % among the nine companies. The reduction was followed by a rapid increase in the rate of meningococcal carriage. One hundred and nineteen rifampin-resistant strains (73.5 % of the positive cultures) were isolated just after administration of the drug. This proportion of resistant strains dropped to approximately 30% by the time the study group departed. The carrier rate among a new group of trainees was 64.2 %, and all 524 isolates were sensitive to rifampin. No rifampin-resistant organisms were isolated from any of the men before treatment or from the controls at any time. Timely administration may interrupt epidemics of meningococcal disease, but its long term use in a closed population should be discouraged.

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