Neisseria (Meningococcal) Meningitis: Post-Exposure Prophylaxis
Standing Orders for Registered Nurses to Administer Ciprofloxacin
Purpose: To authorize Employee Health Services (EHS) registered nurses to provide
Ciprofloxacin to healthcare workers reporting exposures to Neisseria (meningococcal)
meningitis to ensure timely access to post-exposure treatment when the Employee Health nurse
practitioner and/or physician is not readily available.
Policy: Ciprofloxacin will be provided by the EHS registered nurses in accordance with the
guidelines in this standing order and TGH policy IC-13, Neisseria meningitidis and HCW
Exposure.
Procedure:
EHS registered nurse will follow the guidelines below to provide Ciprofloxacin to healthcare
workers reporting exposures to Neisseria Meningitis.
1) Review the “Neisseria (Meningococcal) Meningitis Exposure Evaluation” form
completed by the exposed healthcare worker to include:
a.
b.
c.
d.
e.
Source patient’s name
Date, time and location of exposure
Healthcare worker allergies and current medications
Healthcare worker pregnancy status
Description of exposure by healthcare worker
2) Reviews Ciprofloxacin contraindications with exposed healthcare worker to include:
a. Persons who are or may be pregnant
b. Persons who have had an allergic reaction to Ciprofloxacin or other quinolone
medications (i.e. NegGam, Uroxin, Enroxil, Noroxin, Floxin, Levaquin, Avelox)
3) If Ciprofloxacin is not contraindicated and the healthcare worker requests and/or meets
the criteria for post-exposure prophylaxis, the registered nurse will:
a. Administer Ciprofloxacin 500mg x1
b. Review the administration instructions for Ciprofloxacin with the exposed healthcare
worker on the “Healthcare Worker Exposure to Meningococcal Meningitis” form to
include:
1. Take the medication with a full glass of water preferably two hours after a meal.
2. Do not take Ciprofloxacin with foods containing large amounts of calcium such as
milk, cheese, ice cream or yogurt.
3. Persons taking antacids, vitamins, iron supplements or carafate should take them
2 hours after or 6 hours before taking the Ciprofloxacin.
c. Review the potential adverse effects of Ciprofloxacin to include:
1. GI disturbances such as nausea, diarrhea, stomach pains, vomiting
2. Dizziness or headaches
3. Allergic reactions such as hives, shortness of breath, facial swelling)
d. Provides the healthcare worker with a copy of the “Healthcare Worker Exposure to
Meningococcal Meningitis” information form.
4) Refers healthcare workers who have contraindications to Ciprofloxacin to the Employee
Health nurse practitioner to determine the need for alternative treatment.
5) Instructs the healthcare worker to call Employee Health or report to the Emergency
Room if the healthcare worker develops any serious signs or symptoms of meningitis
such as headache, stiff neck, fever and sore throat within two weeks of the exposure.
6) Completes the EHS section of the exposure evaluation form and enters into EHS
database. Consults with EHS ARNP/MD as indicated.
____________________________________
Director, EHS
________________________
Date
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Medical Director, EHS
________________________
Date
_________________________________
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Date