Meningococcal disease is a contagious, bacterial disease caused by Neisseria meningitidis (N. meningitidis) that often rapidly leads to death. Administering antibiotics as soon as the condition is suspected, and while waiting for the diagnosis to be confirmed, has been advocated as a method of preventing death and the disabling consequences of this disease.
We found no randomized controlled trials that compared pre-admission antibiotics with placebo or no intervention. In the one randomized controlled trial we identified (510 participants), a single injection of either ceftriaxone (a newer antibiotic) or a long-acting form of chloramphenicol (an older antibiotic) were found to be equally effective in preventing death and the disabling consequences in suspected, non-severe cases of meningococcal disease. Due to the serious complications of meningococcal disease, it would be difficult, for ethical reasons, to undertake randomized controlled trials comparing the use of antibiotics as soon as the diagnosis is suspected, versus no antibiotics. However, further trials comparing different antibiotics in suspected meningococcal cases, especially in more severe forms, will provide insights that could help prevent death and the serious consequences of this disease.