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It has become standard that close contacts of individuals being treated for bacterial meningitis be treated prophalacticly with antibiotics to prevent additional cases. Fluoroquinolones, in particular ciprofloxicin, have been the drug of choice as a single dose provided adequate protection.
Now the CDC is reporting the first cluster of fluoroquinolone-resistant meningococcal disease in North America have been documented along the Minnesota-North Dakota border. As of now, the CDC still recommends ciprofloxacin for all parts of the country except for a 34-county area in the Minnesota-North Dakota area. In that area the CDC is recommending rifampin, ceftriaxone or azithromycin be used.
This needs to be followed closely as the resistant organism is extremely likely to spread across the country and it will probably this time next year when nobody can use ciprofloxacin anymore.