Neisseria meningitidis prophylaxis in adults treated with eculizumab

This section includes regimens for antibiotic prophylaxis against Neisseria meningitidis in adults treated with eculizumab for paroxysmal nocturnal haemoglobinuria and atypical haemolytic uraemic syndrome.

Patients treated with eculizumab are at greater risk of invasive meningococcal disease. Immunisation is required before, or at the time of, starting therapy with eculizumab. For meningococcal disease immunisation recommendations, see the Australian Immunisation Handbook [URL].

Note: All patients treated with eculizumab require antibiotic prophylaxis against N. meningitidis.

Antibiotic prophylaxis against N. meningitidis is recommended in all patients treated with eculizumab, including those that have been immunised, because cases of invasive meningococcal disease have occurred in immunised patients. Start prophylaxis at the same time as eculizumab therapy. Use:

1 amoxicillin 250 mg orally, daily. Continue prophylaxis for the duration of treatment with eculizumab and for 60 days after stopping eculizumab neisseria meningitidis, prophylaxis (immunocompromised adult without HIV) amoxicillin    

OR

1 phenoxymethylpenicillin 250 mg orally, 12-hourly. Continue prophylaxis for the duration of treatment with eculizumab and for 60 days after stopping eculizumab. neisseria meningitidis, prophylaxis (immunocompromised adult without HIV) phenoxymethylpenicillin    

For patients hypersensitive to penicillins , seek expert advice.