What antibiotic is used for prophylaxis in close contacts of confirmed meningococcal meningitis cases?

The antibiotic used for prophylaxis in close contacts of confirmed meningococcal meningitis cases is rifampin. This is due to its effectiveness in eradicating Neisseria meningitidis from the nasopharynx, thus reducing the risk of transmission among close contacts. Prophylactic treatment is particularly important for individuals who have been in close proximity to someone diagnosed with meningococcal meningitis, such as household members, intimate contacts, or those who shared a location, like a dormitory.

Rifampin is preferred because it can be given in a short course and has a favorable safety profile for this purpose. The other options, while they have important roles in treating various infections, are not standard recommendations for meningococcal prophylaxis. Ciprofloxacin is also effective against Neisseria meningitidis and can be used for prophylaxis, but rifampin is more commonly recommended, especially in specific populations (e.g., children and those with contraindications to other antibiotics). Ceftriaxone is primarily used for treatment rather than prophylaxis, and azithromycin is generally not recommended for this specific indication.