Treatment: Treatment requires prompt recognition of symptoms and immediate intravenous antibiotic therapy. Any close contacts of the patient should be screened for evidence of disease and given prophylactic oral therapy to decrease the potential of an epidemic. The main intravenous antibiotic of choice is ceftriaxone, followed by penicillin or by chloramphenicol in penicillin-allergic patients. Patients with Waterhouse-Friderichsen syndrome need adrenal gland replacement therapy.
Contacts should be treated with ciprofloxacin, rifampin, or ceftriaxone. This prophylactic therapy, as well as intravenous therapy, should be started immediately if clinical suspicion is high enough; delaying therapy for even a few hours to wait for laboratory confirmation can be the difference between life and death.
Immunization is helping to keep the disease incidence low, and guidelines have been established for which high-risk groups should get the vaccine and when. Although the vaccine protects against only 4 of the 13 serotypes of N. meningitidis, it has the potential to decrease the incidence of this disease and save many lives.
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