05-05-2010
Προ διημέρου 3-5-2010, εμφανίστηκε κρούσμα μικροβιακής μηνιγγίτιδας, σε παιδί γυμνασίου στο Γαλάτσι. Μέχρι σήμερα το παιδί νοσηλεύεται σε παιδιατρικό νοσοκομείο εκτός κινδύνου. Σύμφωνα με οδηγίες του ΚΕΕΛΠΝΟ, χρήζουν χημειοπροφύλαξης τα άτομα που ήλθαν σε στενή επαφή τις προηγούμενες 7 ημέρες.
Θα ήταν φρόνιμο να επικοινωνήσουν με το προσωπικό τους ιατρό για περισσότερες οδηγίες.
Χημειοπροφύλαξη σε μηνιγγίτιδα από το emedicine
* Prophylaxis for close contacts of patients with (suspected) N meningitidis
*
o Indicated for those at increased risk, such as those who were in close contact with patient for at least 4 hours during the week before onset (eg, house mates, daycare center, cell mates) or were exposed to patient`s nasopharyngeal secretions (eg, kissing, mouth-to-mouth resuscitation, intubation, nasotracheal suctioning). Spread is via respiratory droplets, not aerosols, hence close contact is required for prophylactic consideration.
o H influenzae – Rifampin (pediatric dose: 10 mg/kg; (δηλ 0,5ml/kg/δόση * 2 την ημέρα για 2ημέρες) adult dose: 600 mg PO bid) for 4 doses;
o Neisseria – Rifampin (pediatric dose: children 1 mo – 10 mg/kg q12h; adult dose: 600 mg PO bid) for 4 doses
o Alternative – Ciprofloxacin (adults) 500 mg PO single dose or ceftriaxone ( 15 y: 250 mg) IM single dose
o Primary treatment in many European countries – Spiramycin (pediatric dose: 10 mg/kg; adult dose: 500 mg) PO q6h for 5 days
o Administer meningococcal vaccine only in established epidemics or in travelers to countries where meningococcal disease is currently epidemic. Vaccination does not replace prophylaxis.
* Prophylaxis for household or daycare contacts of patients with (suspected) H influenzae type b is controversial. Most authorities treat contacts to protect unvaccinated children, especially those younger than 4 years who are at risk.
*
o Indicated for those residing with the patient for at least 4 hours during the week before illness onset (if at least 1 unvaccinated child 4 years or younger, give prophylaxis to all except pregnant household contacts) or daycare contact with patient within 5-7 days (for single case: if all contacts at least 2 years, no prophylaxis; if unvaccinated children 2 years or younger attend, consider prophylaxis and vaccinate susceptible children. For 2 or more cases in 60 days: if unvaccinated children attend, prophylaxis recommended for children and personnel).
o Rifampin (pediatric dose: 10 mg/kg; adult dose: 600 mg) PO q12h x 4 doses
Κυκλοφορούν στην Ελλάδα:
Syr Rifadin 100mg/5ml και Caps Rifadin 300mg – 600mg
Caps Ciproxin 500mg
Μάριος Ανδρέου
Παιδίατρος
Υπεύθυνος ΚΠΜ
