Chemoprophylaxis of meningitis caused by Neisseria meningitidis and Haemophilus influenzae may be determined by the epidemiology of transmission, the antibiotic susceptibility patterns of the organisms, and the usage of vaccines. A review of transmission in England distinguishes differences in sporadic and cluster meningococcal infections. Because of resistance to sulphadiazine, rifampicin and ciprofloxacin are prophylactic agents of choice. Vaccination can be a useful adjunct to antibiotic prophylaxis. Prophylaxis for meningitis due to H. influenzae type b can be provided by rifampicin and vaccination can also be an adjunct to antibiotic prophylaxis.