{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T22:16:02Z","timestamp":1759011362911},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T00:00:00Z","timestamp":1579737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"German National Reference Laboratory for Meningococci and Haemophilus influenzae"},{"name":"Robert Koch Institute","award":["1369\u2013237"],"award-info":[{"award-number":["1369\u2013237"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Post-exposure prophylaxis (PEP) for close contacts of invasive meningococcal disease (IMD) cases is recommended in most countries to avoid secondary cases by eradicating supposed meningococcal colonization. Currently, rifampicin, ciprofloxacin and ceftriaxone are recommended in many countries including Germany. Azithromycin has been shown to eradicate meningococcal colonization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the azithromycin susceptibility of invasive Neisseria meningitidis isolates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A subset of German invasive meningococcal isolates from 2006\u201318 was selected for this study. Azithromycin MIC was determined using broth microdilution and agar gradient diffusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Azithromycin MICs as determined by broth microdilution ranged from &amp;lt;0.003 to 2\u2009mg\/L (median 0.50\u2009mg\/L, Q75 1\u2009mg\/L). All isolates were susceptible to azithromycin according to the CLSI breakpoint (95% CI 0.0%\u20131.5%). There was no significant correlation between MICs determined by broth microdilution and agar gradient diffusion. Nevertheless, the two methods were consistent regarding the categorization of all isolates as susceptible.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Azithromycin is an eligible antibiotic for PEP of IMD close contacts. It is approved for adults as well as children and may even be used in pregnancy. Because of easier application and lower toxicity, it might be an alternative to rifampicin and ciprofloxacin, as we found no resistant isolates. Since a gonococcal gene associated with elevated azithromycin MICs has been reported in N. meningitidis, careful monitoring of the emergence of resistant strains is nevertheless necessary for meningococci. Lack of concordance of MICs between broth microdilution and agar gradient diffusion needs to be considered.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz535","type":"journal-article","created":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T20:10:02Z","timestamp":1575490202000},"page":"984-987","source":"Crossref","is-referenced-by-count":8,"title":["Susceptibility of invasive Neisseria meningitidis strains isolated in Germany to azithromycin, an alternative agent for post-exposure prophylaxis"],"prefix":"10.1093","volume":"75","author":[{"given":"Manuel","family":"Krone","sequence":"first","affiliation":[{"name":"Institute for Hygiene and Microbiology, National Reference Laboratory for Meningococci and Haemophilus influenzae, University of W\u00fcrzburg, Josef-Schneider-Str. 2\/E1, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thi\u00ean-Tr\u00ed","family":"L\u00e2m","sequence":"first","affiliation":[{"name":"Institute for Hygiene and Microbiology, National Reference Laboratory for Meningococci and Haemophilus influenzae, University of W\u00fcrzburg, Josef-Schneider-Str. 2\/E1, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Vogel","sequence":"first","affiliation":[{"name":"Institute for Hygiene and Microbiology, National Reference Laboratory for Meningococci and Haemophilus influenzae, University of W\u00fcrzburg, Josef-Schneider-Str. 2\/E1, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heike","family":"Claus","sequence":"first","affiliation":[{"name":"Institute for Hygiene and Microbiology, National Reference Laboratory for Meningococci and Haemophilus influenzae, University of W\u00fcrzburg, Josef-Schneider-Str. 2\/E1, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,1,23]]},"reference":[{"key":"2020031310475150400_dkz535-B1","first-page":"R195","article-title":"A retrospective survey of clusters of meningococcal disease in England and Wales, 1993 to 1995: estimated risks of further cases in household and educational settings","volume":"7","author":"Hastings","year":"1997","journal-title":"Commun Dis Rep CDR Rev"},{"key":"2020031310475150400_dkz535-B2","doi-asserted-by":"crossref","first-page":"e272","DOI":"10.1016\/S1473-3099(18)30124-5","article-title":"Mass chemoprophylaxis for control of outbreaks of meningococcal disease","volume":"18","author":"McNamara","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2020031310475150400_dkz535-B3","doi-asserted-by":"crossref","first-page":"23","DOI":"10.2807\/1560-7917.ES.2016.21.5.30125","article-title":"European public health policies for managing contacts of invasive meningococcal disease cases better harmonised in 2013 than in 2007","volume":"21","author":"Vygen","year":"2016","journal-title":"Euro Surveill"},{"key":"2020031310475150400_dkz535-B4","first-page":"173","article-title":"Emergence of fluoroquinolone-resistant Neisseria meningitidis\u2014Minnesota and North Dakota, 2007-2008","volume":"57","year":"2008","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2020031310475150400_dkz535-B5","first-page":"333","article-title":"Recommendations of the Standing Committee on Vaccination (STIKO) at the Robert Koch Institute \u2013 2017\/2018","volume":"34","year":"2017","journal-title":"Epid Bull"},{"key":"2020031310475150400_dkz535-B6","first-page":"CD004785","article-title":"Antibiotics for preventing meningococcal infections","volume":"8","author":"Zalmanovici Trestioreanu","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"2020031310475150400_dkz535-B7","year":"2018"},{"key":"2020031310475150400_dkz535-B8","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1017\/S0950268808001398","article-title":"Outbreak of meningococcal disease in and around New Delhi, India, 2005-2006: a report from a tertiary care hospital","volume":"137","author":"Nair","year":"2009","journal-title":"Epidemiol Infect"},{"key":"2020031310475150400_dkz535-B9","doi-asserted-by":"crossref","first-page":"819","DOI":"10.2165\/00003088-200342090-00003","article-title":"Pharmacokinetic interactions with rifampicin: clinical relevance","volume":"42","author":"Niemi","year":"2003","journal-title":"Clin Pharmacokinet"},{"key":"2020031310475150400_dkz535-B10","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/0140-6736(93)93171-V","article-title":"Rifampicin-resistant meningococci causing invasive disease and failure of chemoprophylaxis","volume":"341","author":"Yagupsky","year":"1993","journal-title":"Lancet"},{"key":"2020031310475150400_dkz535-B11","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1097\/00006454-199809000-00013","article-title":"Azithromycin compared with rifampin for eradication of nasopharyngeal colonization by Neisseria meningitidis","volume":"17","author":"Girgis","year":"1998","journal-title":"Pediatr Infect Dis J"},{"key":"2020031310475150400_dkz535-B12","doi-asserted-by":"crossref","first-page":"3162","DOI":"10.1128\/JCM.43.7.3162-3171.2005","article-title":"Susceptibility of Neisseria meningitidis to 16 antimicrobial agents and characterization of resistance mechanisms affecting some agents","volume":"43","author":"Jorgensen","year":"2005","journal-title":"J Clin Microbiol"},{"key":"2020031310475150400_dkz535-B13","doi-asserted-by":"crossref","first-page":"ofv117.","DOI":"10.1093\/ofid\/ofv117","article-title":"Population-based surveillance of Neisseria meningitidis antimicrobial resistance in the United States","volume":"2","author":"Harcourt","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"2020031310475150400_dkz535-B14","year":"2019"},{"key":"2020031310475150400_dkz535-B15","year":"2018"},{"key":"2020031310475150400_dkz535-B16","year":"2019"},{"key":"2020031310475150400_dkz535-B17","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1128\/AAC.32.5.752","article-title":"In vitro activities of azithromycin (CP 62,993), clarithromycin (A-56268; TE-031), erythromycin, roxithromycin, and clindamycin","volume":"32","author":"Barry","year":"1988","journal-title":"Antimicrob Agents Chemother"},{"key":"2020031310475150400_dkz535-B18","doi-asserted-by":"crossref","first-page":"609.","DOI":"10.1186\/s12879-018-3528-4","article-title":"Stably high azithromycin resistance and decreasing ceftriaxone susceptibility in Neisseria gonorrhoeae in 25 European countries, 2016","volume":"18","author":"Day","year":"2018","journal-title":"BMC Infect Dis"},{"key":"2020031310475150400_dkz535-B19","doi-asserted-by":"crossref","first-page":"176.","DOI":"10.1186\/s12864-018-4560-x","article-title":"Expansion of a urethritis-associated Neisseria meningitidis clade in the United States with concurrent acquisition of N. gonorrhoeae alleles","volume":"19","author":"Retchless","year":"2018","journal-title":"BMC Genomics"},{"key":"2020031310475150400_dkz535-B20","doi-asserted-by":"crossref","first-page":"18.","DOI":"10.1186\/1471-2393-6-18","article-title":"Pregnancy outcome following gestational exposure to azithromycin","volume":"6","author":"Sarkar","year":"2006","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jac\/article-pdf\/75\/4\/984\/32903555\/dkz535.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jac\/article-pdf\/75\/4\/984\/32903555\/dkz535.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,3,13]],"date-time":"2020-03-13T14:48:39Z","timestamp":1584110919000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/75\/4\/984\/5714632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,23]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,1,23]]},"published-print":{"date-parts":[[2020,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkz535","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4]]},"published":{"date-parts":[[2020,1,23]]}}}