Rifampin frequently is used as
chemoprophylaxis for close contacts of patients who have invasive meningococcal
disease. Close contacts include persons who have
eaten or slept frequently in the same
dwelling during the 7 days prior to the onset of the disease. Regimens of
rifampin, ceftriaxone, or ciprofloxacin are appropriate
for patients 18 years of age and older.
Rifampin penetrates the central nervous system and is found in most body fluids. It can cause orange-colored secretions, including urine, sweat, and tears. Patients should be advised that contact lenses may be stained orange.
Rifampin is metabolized by the liver and excreted in bile and urine. It can alter the serum concentrations of many drugs and possibly interfere with the efficacy of oral contraceptives. The reliability of intramuscular medroxyprogesterone is not altered with rifampin use. Neither rifampin nor ciprofloxacin is recommended for use during pregnancy. A single intramuscular dose of ceftriaxone is the recommended prophylaxis during pregnancy.
Rifampin therapy is not contraindicated for patients who have asthma, although its use may decrease the efficacy of corticosteroids. Reactive arthritis is not a common adverse reaction associated with rifampin.
American Academy of Pediatrics. Meningococcal infections: control
measures. In: Pickering LK, ed. 2000 Red Book: Report of the Committee
on Infectious Diseases. 25th ed. Elk Grove Village, Ill: American
Academy of Pediatrics; 2000:399-400
American Academy of Pediatrics. Tuberculosis: treatment, specific
drugs (rifampin). In: Pickering LK, ed. 2000 Red Book: Report of the
Committee on Infectious Diseases. 25th ed. Elk Grove Village, Ill:
American Academy of Pediatrics; 2000:599-604