Use of josamycin in the eradication of meningococcus

Because of their in vitro and in vivo activity on Neisseria meningitidis, good salivary and tonsillar tissue levels, high safety and non-penetration through the meningeal barrier, macrolides are agents of choice for treating Meningococcus carriers. To assess the value of josamycin for eliminating Meningococci in carriers, we carried out a 14-month study with bacteriological control. 27 carriers identified (throat specimens) among contacts of 28 children with meningococcal meningitis hospitalized in Pediatrics at the Amiens and Toulouse CHU (teaching hospitals) were treated. Josamycin was given in a dosage of 50 mg/kg/day in children and 2 g/day in adults, in two divided doses daily, for six days. Bacteriologic control at the end of treatment showed that every study patient was free of Meningococci. In vitro, strains recovered from carriers were inhibited by josamycin at concentrations of 0.25 to 1 microgram/l. Given its safety and efficacy, josamycin is well suited to prophylaxis of meningococcal infections.