Meningococcal disease

The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.

Parenteral antibiotics should be given at the earliest opportunity, either in primary or secondary care, but urgent transfer to hospital should not be delayed in order to give the parenteral antibiotic.

Intramuscular or intravenous 1.2g.

Refer to local guidance.

Prescribing Notes:

If meningococcal disease is suspected, the responding clinician should give a single dose of benzylpenicillin or cefotaxime before urgent transfer to hospital. The only contra-indication is a history of true penicillin anaphylaxis; in this case, giving penicillin or an alternative antibiotic may carry increased risk of anaphylactic reactions, and urgent transfer to hospital is the most important measure. Patients with non-severe penicillin allergies may receive cefotaxime.
Public Health should be notified to arrange antibiotic prophylaxis for close (household and kissing) contacts of meningococcal disease.
For further information including advice on vaccination of the index case and close contacts refer to:
- Public Health England: Meningococcal disease: guidance on public health management
- Public Health Scotland: Guidance for professionals - Meningococcal disease

History Notes

30/07/2026

Regional formulary chapter launched.

Public Health should always be contacted in the first instance.

500mg given immediately.

For close contacts where there has been recent travel to the Middle East or Asia.

600mg twice daily for 2 days.

Prescribing Notes:

Ciprofloxacin chemoprophylaxis for contacts is recommended for all ages and in pregnancy.
Ciprofloxacin 250mg tablets are more cost-effective dose for dose than 500mg tablets.
Refer to BNF important safety information for all quinolones prior to prescribing.
See MHRA Drug Safety Update (January 2024): Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as:
- there is resistance to other first-line antibiotics recommended for the infection
- other first-line antibiotics are contraindicated in an individual patient
- other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped
- treatment with other first-line antibiotics has failed
Where an individual is at risk of potential side-effects from ciprofloxacin discuss risk versus benefit and possible alternative options with Public Health.
Public Health should be notified to arrange antibiotic prophylaxis for close (household and kissing) contacts of meningococcal disease.
For further information including advice on vaccination of the index case and close contacts refer to:
- Public Health England: Meningococcal disease: guidance on public health management
- Public Health Scotland: Guidance for professionals - Meningococcal disease

History Notes

30/07/2026

Regional formulary chapter launched.