The California Department of Public Health (CDPH) recommends that healthcare providers throughout California discontinue the use of ciprofloxacin for the post-exposure prophylaxis (PEP) of invasive meningococcal disease (IMD) due to the rise of ciprofloxacin-resistant strains of Neisseria meningitidis.
Rifampin, ceftriaxone, or azithromycin are the recommended options for IMD PEP in California. No changes to empiric treatment of IMD are currently recommended.
Earlier in 2024, the Southern California region met the threshold to discontinue ciprofloxacin IMD PEP. CDPH is now issuing this recommendation statewide.