Invasive Haemophilus influenzae type b (Hib) infection

Prophylaxis with rifampicin is recommended for 

·        the patient themselves prior to discharge from hospital, if the patient has not been treated for at least 3 days with an antibiotic that also eradicates carriage, namely ceftriaxone or cefotaxime; 

·        all household members and very close contacts* of the index patient if there are children < 4 years in the household who are unvaccinated or only partially vaccinated;

·        all household members and very close contacts* of the index patient if an immunocompromised child (regardless of age) is part of the household;

·        contacts of the index patient in a daycare setting, regardless of age, if two or more cases of invasive Hib infection occur within 60 days after onset of illness in the index patient.

* Definition of very close contacts: persons who, during the 7 days before onset of illness in the index patient, have slept one or more times in the same room as the index case, or who have had intensive contact with the index case in the same household for 4 hours or longer (continuous). 

Dosage

Rifampicin 20 mg/kg orally (maximum 600 mg/day; infants up to one month of age 10 mg/kg) given once daily for four days; contraindicated in pregnancy. A possible side effect is red discolouration of urine, tears and sputum. 

A single intramuscular dose of ceftriaxone 250 mg is an alternative during pregnancy.