Dear Dr.

Your patient  ____________________________         ______________

                                        Name                                                           DOB

presented to the Emergency Department for meningococcal prophylaxis.

They did/did not meet the following criteria for prophylaxis:

• Household contact
• Contact > 1 hour
• Exposure to oral secretions including kissing/sharing food/drink/cigarettes
• Attending same class at school/day care centre (not different class)
• Attending same school/day care centre/place of work AND > 1 case affected

They did not manifest any of the clinical features of meningitis or septicaemia namely:

• Fever/Chills
• Malaise
• Headache
• Photophobia
• Neck stiffness
• Rash
• Drowsiness

The were/were not administered prophylactic antibiotics and were given (circle one):

Ceftriaxone 5mg/kg (max 250mg) stat IM

    OR

Ciprofloxacin 500mg stat orally [not in children < 12 y.o.]

    OR

Rifampicin 10mg/kg (max 600mg) bd for 2 days [not in pregnancy]

The patient was given medication advice as required, discharged and advised to return if they manifested any of the symptoms of infection:

Yours Sincerely,

(Signed)