| Drug | Age group | Dose | Duration and route of administration |
| Preferred regimens | |||
| Rifampin* | Infants age <1 month | 5 mg/kg/dose every 12 hours | 2 days (4 doses) of oral therapy |
| Infants and children age ≥1 month | 10 mg/kg/dose (maximum: 600 mg) every 12 hours | 2 days (4 doses) of oral therapy | |
| Adults | 600 mg every 12 hours | 2 days (4 doses) of oral therapy | |
| Ciprofloxacin¶ | Infants and children age ≥1 month | 20 mg/kg (maximum 500 mg) | Single oral dose |
| Adults | 500 mg | Single oral dose | |
| Ceftriaxone | Children age <15 years | 125 mg | Single IM dose |
| Adults and adolescents age ≥15 years | 250 mg | Single IM dose | |
| Alternative regimen (eg, if rifampin or ceftriaxone cannot be used in the setting of ciprofloxacin-resistant Neisseria meningitidis exposure) | |||
| AzithromycinΔ | Infants and children | 10 mg/kg (maximum 500 mg) | Single oral dose |
| Adults | 500 mg | Single oral dose | |
IM: intramuscular.
* Rifampin is not recommended for pregnant women because the drug is teratogenic in laboratory animals. Because the reliability of oral contraceptives might be affected by rifampin therapy, consideration should be given to using alternative contraceptive measures while rifampin is being administered. For additional information on drug interactions, refer to the Lexicomp drug interaction program within UpToDate.
¶ Ciprofloxacin should not be used if fluoroquinolone-resistant strains of N. meningitidis have been identified in the community. In addition, ciprofloxacin is not recommended for pregnant women. Although systemic fluoroquinolones are not routinely used as a first-line agent in children less than 18 years of age, it is reasonable to use a single dose of ciprofloxacin for chemoprophylaxis for meningococcal disease.
Δ Although azithromycin has activity against meningococcus, it has not been well studied for this indication.