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People who have close contact to patients with invasive Neisseria meningitidis infections have an increased risk for infection within 2 weeks after exposure. Given the high disease severity, such contacts are advised to take postexposure prophylaxis (PEP) to eradicate colonization and thus prevent secondary cases. N. meningitidis prophylaxis is also recommended by the CDC for patients who take the complement inhibitors eculizumab and ravulizumab. First-line recommended drugs for this use are ciprofloxacin, rifampin, or ceftriaxone (MMWR Recomm Rep 2013; 62(RR-2):23). However, these agents pose potential problems, including Clostridioides difficile diarrhea (CDD) and tendinopathy with ciprofloxacin, drug interactions with rifampin, or need f…