605 EFFECT OF RIFAMPIN ON NASOPHARYNGEAL FLORA FOLLOWING PROPHYLAXIS FOR H. INFLUENZAE CARRIAGE

Abstract

Rifampin (Rf) is currently recommended as prophylaxis for household and day-care center contacts of patients with H. influenzae invasive diseases. Rapid development of bacterial resistance (R) to this drug is well-documented. Because Rf plays an important role in treatment of other conditions such as staphylococcal infections, streptococcal carriage, and TB, we investigated the effect of Rf 20 mg/kg once a day for 4 days on the nasopharyngeal (NP) flora of 17 children. NP swabs were obtained before Rf prophylaxis and 48 hrs post therapy. As shown in the Table, the vast majority of the isolates recovered before Rf treatment were sensitive (S) to Rf, while the large majority isolated following Rf prophylaxis were Rf resistant (MIC ≥ 5 μg/ml).

This rapid development of Rf resistant flora in our population suggests the possible need to re-evaluate current prophylaxis recommendations either to limit the treated population or to add another anitbiotic in order to prevent emergence of R strains.

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