Antibiotics for preventing meningococcal infections

Abigail Fraser; Anat Gafter‐Gvili; Mical Paul; Leonard Leibovici

doi:10.1002/14651858.CD004785.pub3

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Analysis 1.1

Comparison 1 Failure to eradicate (follow up: up to one week), Outcome 1 Ciprofloxacin versus placebo.

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Analysis 1.2

Comparison 1 Failure to eradicate (follow up: up to one week), Outcome 2 Rifampin versus placebo.

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Analysis 1.3

Comparison 1 Failure to eradicate (follow up: up to one week), Outcome 3 Minocycline versus placebo.

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Analysis 1.4

Comparison 1 Failure to eradicate (follow up: up to one week), Outcome 4 Penicillin versus placebo.

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Analysis 1.5

Comparison 1 Failure to eradicate (follow up: up to one week), Outcome 5 Other antibiotics versus placebo.

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Analysis 1.6

Comparison 1 Failure to eradicate (follow up: up to one week), Outcome 6 Rifampin versus ciprofloxacin.

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Analysis 1.7

Comparison 1 Failure to eradicate (follow up: up to one week), Outcome 7 Rifampin versus ceftriaxone.

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Analysis 2.1

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 1 Ciprofloxacin versus placebo.

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Analysis 2.2

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 2 Rifampin versus placebo.

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Analysis 2.3

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 3 Minocycline versus placebo.

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Analysis 2.4

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 4 Penicillin versus placebo.

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Analysis 2.5

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 5 Other antibiotics versus placebo.

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Analysis 2.6

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 6 Rifampin versus ciprofloxacin.

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Analysis 2.7

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 7 Rifampin versus ceftriaxone.

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Analysis 2.8

Comparison 2 Failure to eradicate (follow up: one to two weeks), Outcome 8 Rifampin versus minocycline.

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Analysis 3.1

Comparison 3 Failure to eradicate (follow up: between two to three weeks), Outcome 1 Rifampin versus placebo.

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Analysis 4.1

Comparison 4 Failure to eradicate (follow up between three to four weeks), Outcome 1 Rifampin versus placebo.

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Analysis 4.2

Comparison 4 Failure to eradicate (follow up between three to four weeks), Outcome 2 Penicillin versus placebo.

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Analysis 5.1

Comparison 5 Failure to eradicate (follow up: five weeks), Outcome 1 Rifampin versus minocycline.

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Analysis 6.1

Comparison 6 Adverse effects, Outcome 1 Rifampin versus ceftriaxone.

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Analysis 6.2

Comparison 6 Adverse effects, Outcome 2 Rifampin versus ciprofloxacin.

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Analysis 7.1

Comparison 7 Exclusion after randomisation, Outcome 1 Drop‐outs.

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Table 1. Carrier rates

Study ID	Comparison	Study population	% carriers (N)
Blakebrough 1980	Rifampin versus sulphadimidine	Household contacts	17 (479)
Borgono 1981	Rifampin versus placebo	Children	12 (2132)
Cuevas 1995	Rifampin versus ciprofloxacin versus ceftriaxone	Household contacts	11 (1875)
Deal 1969b	Rifampin versus placebo	Students	14.4 (270)
Deal 1969a	Cephalexin versus placebo	Students	9.4 (352)
Devine 1970b	Rifampin versus placebo	Military recruits	64 (103)
Devine 1971a	Minocycline versus placebo	Military recruits	72 (121)
Devine 1970a	Coumermycin A1 versus placebo	Military recruits	55 (129)
Dworzack 1988	Ciprofloxacin versus placebo	Volunteers	6.7 (620)
Girgis 1998	Azithromycin versus placebo	Students	24 (500)
Guttler 1971	Rifampin versus minocycline	Military recruits	21 (587)
Kaiser 1974	Rifampin versus placebo	Household contacts	35 (54)
Kaya 1997	Ciprofloxacine versus rifampin	Hospital staff	18 (300)
Munford 1974	Rifampin versus minocycline versus minocycline/rifampin versus sulphadiazine	Household contacts	25 (1187)
Pugsley 1984	Sch 29,482 versus placebo	Volunteers	25 (555)
Pugsley 1987	Ciprofloxacin versus placebo	Students	7 (461)
Renkonen 1987	Ciprofloxacin versus placebo	Military recruits	38.6 (552)
Schwartz 1988	Rifampin versus ceftriaxone	Household contacts	33 (347)
Simmons 2000	Rifampin versus ceftriaxone	Household contacts	21 (864)

Table 1. Carrier rates

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Comparison 1. Failure to eradicate (follow up: up to one week)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Ciprofloxacin versus placebo Show forest plot	3	197	Risk Ratio (M‐H, Fixed, 95% CI)	0.04 [0.01, 0.12]

2 Rifampin versus placebo Show forest plot	6	725	Risk Ratio (M‐H, Fixed, 95% CI)	0.17 [0.13, 0.24]

3 Minocycline versus placebo Show forest plot	3	464	Risk Ratio (M‐H, Fixed, 95% CI)	0.28 [0.21, 0.37]

4 Penicillin versus placebo Show forest plot	2	386	Risk Ratio (M‐H, Random, 95% CI)	0.47 [0.24, 0.94]

5 Other antibiotics versus placebo Show forest plot	3		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

6 Rifampin versus ciprofloxacin Show forest plot	2	218	Risk Ratio (M‐H, Fixed, 95% CI)	0.34 [0.11, 1.02]

7 Rifampin versus ceftriaxone Show forest plot	2	286	Risk Ratio (M‐H, Random, 95% CI)	3.71 [0.73, 18.86]

Comparison 1. Failure to eradicate (follow up: up to one week)

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Comparison 2. Failure to eradicate (follow up: one to two weeks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Ciprofloxacin versus placebo Show forest plot	1	42	Risk Ratio (M‐H, Fixed, 95% CI)	0.03 [0.00, 0.42]

2 Rifampin versus placebo Show forest plot	5	495	Risk Ratio (M‐H, Fixed, 95% CI)	0.20 [0.14, 0.29]

3 Minocycline versus placebo Show forest plot	2	382	Risk Ratio (M‐H, Random, 95% CI)	0.37 [0.10, 1.31]

4 Penicillin versus placebo Show forest plot	2	386	Risk Ratio (M‐H, Fixed, 95% CI)	0.63 [0.51, 0.79]

5 Other antibiotics versus placebo Show forest plot	3		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

6 Rifampin versus ciprofloxacin Show forest plot	2	218	Risk Ratio (M‐H, Fixed, 95% CI)	0.31 [0.09, 1.11]

7 Rifampin versus ceftriaxone Show forest plot	1	91	Risk Ratio (M‐H, Fixed, 95% CI)	5.93 [1.22, 28.68]

8 Rifampin versus minocycline Show forest plot	2	419	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.57, 1.77]

Comparison 2. Failure to eradicate (follow up: one to two weeks)

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Comparison 3. Failure to eradicate (follow up: between two to three weeks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Rifampin versus placebo Show forest plot	3	326	Risk Ratio (M‐H, Fixed, 95% CI)	0.25 [0.16, 0.37]

Comparison 3. Failure to eradicate (follow up: between two to three weeks)

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Comparison 4. Failure to eradicate (follow up between three to four weeks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Rifampin versus placebo Show forest plot	2	311	Risk Ratio (M‐H, Fixed, 95% CI)	0.24 [0.16, 0.38]

2 Penicillin versus placebo Show forest plot	2	386	Risk Ratio (M‐H, Random, 95% CI)	0.95 [0.53, 1.68]

Comparison 4. Failure to eradicate (follow up between three to four weeks)

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Comparison 5. Failure to eradicate (follow up: five weeks)

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Rifampin versus minocycline Show forest plot	1	89	Risk Ratio (M‐H, Fixed, 95% CI)	0.97 [0.48, 1.97]

Comparison 5. Failure to eradicate (follow up: five weeks)

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Comparison 6. Adverse effects

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Rifampin versus ceftriaxone Show forest plot	1	856	Risk Ratio (M‐H, Random, 95% CI)	1.39 [1.10, 1.75]

2 Rifampin versus ciprofloxacin Show forest plot	2	1598	Risk Ratio (M‐H, Fixed, 95% CI)	0.75 [0.36, 1.56]

Comparison 6. Adverse effects

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Comparison 7. Exclusion after randomisation

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Drop‐outs Show forest plot	13	1260	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.89, 1.15]

1.1 Drop‐outs at around one week of follow up	13	1260	Risk Ratio (M‐H, Fixed, 95% CI)	1.01 [0.89, 1.15]

Comparison 7. Exclusion after randomisation

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