Tag. Excellent thread.

I'm reading my way through this excellent thread. It says at the link you provided that Cipro can also be used to treat for anthrax exposure.... which is also interesting because this website was for pet antibiotics.

It appears that they're onto us.

I'm glad we have your expertise here.

I came over in this direction looking for answers on.  How to get antibiotics for SHTF low and behold.  So tag and thanks for all of the much needed answers/advice

same

deleted



 

Yes, a very big 'thank you' to all who posted this great info.



And mods, you have my vote to pin this one.





 

in all seriousness, though, what is the technique employed by all of you non-rx writers to get rx meds?



the doc prescribes what he prescribes, so how could i just up and purchase a shtf supply of doxycycline?

Read the tread for your answer

got it missed your post on the first page.



thanks

Does this matter?  It's not as though we can choose what we get prescribed to us and in what quantity, if our goal is to build up SHTF supplies, right?



Cipro is about $25 per 20 tabs at Amazon.  If I could get it for $4 that would be awesome.



 

what about antibiotics for eye infections?



opthalmic solutions?

Yes you can.  Well, there is a smartphone app for this but it costs $57



http://www.skyscape.com/estore/ProductDetail.aspx?ProductId=2316&WT.mc_id=83273





Link to free Johns Hopkins ABX Guide (registration required): http://www.hopkins-abxguide.org/
 

It was a LOT cheaper just a few months ago, like $30 for 100 x 500 mg

What about length of regimen?

That's a medical question, not my area.

Picks for oral survival antibiotics:

Dirt cheap stockpilable basic core (TGMs excellent synopsis covers the basics):
Keflex (cephalexin)
Doxycycline
Cipro (ciprofloxacin)
Flagyl  (metronidazole)

Limited quantity specialist set. Most of these are limited due to price, but if you can swing it, I think they are worthwhile.

Levaquin (levofloxacin) –– best agent for treating a serious pneumonia, including resistant respiratory infections. Once daily dosing means easy compliance and low profile. As a single agent covers almost everything short of MRSA including pseudomonas. Oral dosing gives you same bioavailability as IV dosing. Great bone & cartilage penetration. Cons: Very expensive, preggers class C and potential bad side effects in kiddies.

Augmentin (amoxicillin-clavulanate) –– one word: "bites." Does everyting amoxicillin does but also covers penicillin resistant bugs, including oddball streps like milleri and viridans. Decent gram neg and some anaerobe coverage. Cheaper than Levaquin but still moderatley expensive.  Good to go for children and pregnant wimmenz. Twice daily dosing is nice. Cons: no pseudomonas, doesn't get a lot of GI anaerobes

Cleocin (clindamycin) - Great coverage for mouth anaerobes (think tooth infection) and gram positive (staph/strep). Many isolates of MRSA are susceptible to Clinda (but also to cheaper Bactrim and Doxy) . Four-times daily dosing sucks.  Best reason to have this is that you can treat common infections in people allergic to penicillins.

Zithromax (azithromycin) - Covers wierd bugs like zoonoses, and mycoplasma pneumonia (so does doxycyline). Also gets gram positive like strep. Super long half life which is why 5 days of treatment is equivalent to 10-14 days of treatment with anything else. Once daily dosing nice. Cousin Clarithromycin (Biaxin) covers roughly same stuff and is less expensive but is twice daily and have to go with traditional dosing regimen. Safe for preggers and kids (unlike doxycycline).

Albenza (albendazole) - If you are really thinking survival situation, then you have to consider that there might be worms to deal with. Albendazole covers tapeworm, hookworm and filaria. Doesn't cover everything  but it is better than nothing. Very expensive, but most regimens are one-time dosing.

Diflucan (fluconazole) - Reasonably cheap broad spectrum anti-fungal. Doesn't get everything but will knock out a yeast infection with one dose. Believe it or not, unchecked thrush can be very serious. Safe administration. No reason not to have some anti-fungal capability in the box.

Entirely dependent on what you're treating, and how bad it is.  Some clinical judgment required.  Batteries not included.

Is there a refrence for this sort of thing?

The Sanford Guide and the Hopkins antibiotic guide contain suggested regimen lengths. The caveat is that you have to have a decent idea of what you are treating. In a short term survival situation (Katrina II came along and stranded you for a few days) then without any other knowledge, you can probably just treat until you get help and then let someone else decide. In a longer term situation, the length will depend on where and what kind of infection. In general, most regimens are going to be 7-10 days. Most of the time you aren't going to hurt things by erring on the longer side. Again, important to emphasize that there are lots and lots of caveats here. The infection might be a resistant organism or a wierd bug which requires extended treatment. Your person may actually need surgery more than just an antibiotic. I mentioned some of the pregnancy, allergy, and kid stuff above because I wanted people to keep in mind that there are a lot of other issues which affect decisions. You would feel pretty lousy if you gave a pregnant woman something that she wasn't supposed to take and hurt her baby, or gave someone cephalexin and had them go into anaphylaxis because you didn't realize the cross-reactivity issue with early gen cephalosporins and penicillin allergy.

None of this is a substitute for someone who knows what they are doing, and unless it is truly TEOTWAWKI, your goal in almost all cases should be to buy time to get the sick person to a care provider.

From my earlier post:

"The hard part of practicing medicine is not deciding what drug to prescribe, it's deciding what disease the patient has. That, my friend, is what all that training is for and what you and I don't have."

^^ Well said.  Thanks to all ARF docs for imparting your wisdom

Maybe the Merck Manual?

Nevermind, I misunderstood.

Yeah that is the unfortunate part about the John Hopkins ABX guide, but that's why I carefully worded my statement with computer
If you are inclined to go with a cheaper ID (infectious disease) option I would recommend Pusware here is the link to the online version and the iPhone/touch/Pad version available for $5.99 Pusware.  It is not as detailed as the other two mentioned, but if you have medical training it is funny and has some good pearls in it.  Be aware it does have some little jabs written into about certain political leanings/beliefs, just thought I would warn you.

Great thread and great info, but with the exception of Rich I'm seeing some authoritative statements made by individuals here who's qualifications I don't know. Or at least haven't been stated in this thread. Not flaming anyone and of course if it's on the interwebz it must be true... But if any of the rest of you would be so inclined to say on what basis you are making these statements on it would be a constructive thing.

Thanks

Mr B

So it really does no good to have antibiotics on hand if there is no way to safely administer them (i.e. being a doctor)? I thought the whole point behind broad spectrum anti's was to treat different types of infections with one med?

FYI sometimes people don't state their professions as a way to sidestep any sort of "interwebz" liability and some of us have stated our professions in one of the many other medication threads on here (que icon of dead horse being beaten)
However in interest of establishing my "cred" I am PharmD in a hospital, work w/ ABX every single day, Cx, dispense advise to MDs, etc
Everything I post is for entertainment, not actual medical advice, YMMV, etc etc

Safety is relative. I have no doubt that there are people out there who think that getting fish antibiotics over the internet and treating themselves at home is a substitute for medical care. I rather suspect that there may be some people who view this sort of discussion as a cookbook for routine self treatment. I would not consider this safe or responsible. On the other hand, in a survival situation or austere circumstances where there is no medical help availabe, then treating a serious infection yourself might be the only choice –– and may make the difference for life and limb. Most antibiotics have pretty good safety profiles and the most likely "wrong thing" you do would be to treat with the wrong agent for the type of infection. In that case you are no worse off than when you started. It is just important to have some perspective that there is a reason people have to do all that pharmacy/medical school/residency stuff to become competent.

As for the meaning "broad spectrum," we still don't have one single cure-all agent. Some of the IV agents  are very broad spectrum, (some here colloquially refer to Imipenem as "liquid Jesus"), but even then, there is no one size fits all drug. In fact quite the opposite is true. Bacteria were here on this planet long before us, and they will probably long outlast us too. They are much better at adapting to us than we are of finding new ways to kill them. The rule in infectious disease is that the bugs always win in the end. For every antibiotic we develop, bacteria and other pathogens develop resistance and other little tricks to escape anhilation. The other thing here is that most of the antibiotics which are affordable, are older drugs, meaning that they are still effective, but they may not be as broad spectrum, and they may have some funky side effect profiles which make their use less common (e.g. Doxycyline).

Just my way of warning people of what they are attempting to do with antibiotics. Getting the ABs is the easy part, knowing when and what to use is another story.

The best anyone without formal training can do is know what are the dangers associated with each AB they have and what are the general uses for each. TheGrayMan and others have given a short list of ABs and their potential uses.
In a SHTF situation we chose the path of least danger, if that is to take an AB for a gashed leg when medical help is not available then that is up to you.

This.

Well said.

I'm an MD, and board-certified in Emergency Medicine... though I'll likewise add the disclaimer that my posts are not intended to be "medical advice."  The reason why I don't give medical advice over the internet is because of the lawyers, and the litigious people they enable.

Excellent Thread.

Thanks both of you for stepping up, and of course anything posted here is strictly for entertainment value and not medical advice. I don't read SF nearly as much as I once did and had never seen either of you previously post your background although I was pretty sure from that GM was a medical professional of some sort based on what I hjad seen in the past.

Thanks again..

So if you are going to order a variety to have just in case, What quantities of each would you say is prudent? IIRC Doxycycline turns toxic over time, but most of the other ABs are pretty stable. Is that correct?

Thanks for the advice in the thread, gents.

I am starting up a small SHTF supply, and I curently have Doxycycline and Amoxicillin on the way.




Can anyone comment on this?

Awsome info! Will be stocking up for my imaginary fish "Charlie". Poor guy is very sickly....

Well bump because my fish is sick and I ordered some amoxicillian for him. In his usual dose.
Fishy Amox

I am looking at this and what would be a good amount to purchase for a family of 4?  Also would I be better off buying the 500 mg and then just cutting them in half for a lower dose?  What about simple tests for trying to narrow down what is wrong so that the right drug is used?

Bump... with an important addition to my list on page 2.

No, it doesn't.

I would like to thank everyone who contributed.   I am a dumbass when it comes to seeking medical attention (high pain tolerance and a no give up/tough it out disposition) I was on a business trip one time traveling from place to place when I came down with badly infected tooth. Too busy to seek medical attention on the road and too dumb to go when I first got home on Friday night. I suffered all day Saturday and came down with a fever.  Too stubborn to go to the ER ( I hate ERs) but knew I was in trouble.  Found some Amoxycillin that my daughter (Acne) had forgotten to take back to college and started self medicating. Went to the dentist on Monday and he said that since I had a knee replacement in the last year I was lucky that I started on the antibiotics when I did. Knee replacements and oral infections are bad ju-ju.  He prescribed the same thing.

I learned a couple things

First-don't be a dumb ass when it comes to your health
Second-It is good to have back up meds just in case.

Coincidentally, you picked an excellent drug for a tooth infection.

People with artificial joints need to be extra careful... if you seed that joint with bacteria through your bloodstream, you're going to think you're on the ninth circle of hell before it's all over.  You'll have to have another surgery to open up your knee joint, remove the infected hardware, wait for the infection to clear up, and then have a re-do of your joint replacement.

That's a big-ball-o-bullsh*t you don't need.

I apologize if this has already been asked and answered... I do plan on reading the whole thread... but what is the typical course of anti-biotics prescribed following a gunshot wound? Does the course of anti-biotics change depending on where a person is shot (Extremity vs. Abdomen)?

Thanks!

If you're gutshot, antibiotics are not going to help you.  You'll still get peritoneal soilage and peritonitis... and antibiotics don't fix that.

As for the rest, the average rule-of-thumb treatment course is ten days, though that can be greatly extended depending on how the patient responds, and the type of infection.

What about antibiotics for the eyes (drops) ? I know this is a sensitive area, but are there some "pet" alternatives ?
Seems like every so often I get one of those "pink eye" looking things.

Thanks for the response Doc. I appreciate it.

I was particularly interested by your comments about being gutshot.

Not knowing what Peritonitis was, I looked it up and found this:



When you said that anti-biotics won't fix Peritonitis, I assume you meant that they won't fix it by themselves?

Even if anti-biotics won't fix the problem, they will still be prescribed, correct? If so, which anti-biotics would likely be prescribed for the patient?

Of course this is a purely academic question, because if you were gutshot out in the middle of nowhere, with no access to a trauma center, you'd certainly die before infection killed you.

Thanks.

I'm not an MD but I can answer this one.

If you are gut shot and don't get to a surgeon to fix the holes and wash out the shit (literally) you will be dead regardless of how much antibiotic you take. In that circumstance reach for the Morphine self injector and don't stop until you run out or don't care any longer.

My 2 cents

Here's the thing with abdominal GSWs.  Even if you miss a large vessel or solid organ, and merely nick the bowel, you're still in a deep sh*t.... you'll just die more slowly, and in unbelievable pain.  

The hole in the bowel has to be fixed by a surgeon.  It can be over-sewn, or the damaged section removed and an ostomy of some type performed... like a colostmy in the case of the large bowel).  If not, you'll continue to spill intestinal contents into the peritoneal cavity (and remember... about 30% of the dry weight of your fecal stream is pure bacteria) and peritonitis/sepsis will follow.  You MIGHT get lucky and wall off the damaged area, forming a huge intra-abdominal abscess; I've seen that happen a few times over the years... but even that needs to be drained, because that can also make you septic.

Hitting a mesenteric vessel or solid organ will generally result in you bleeding to death, absent a surgeon going in to tie off the offending vessel, or remove the spleen/liver-lobe/kidney that was hit.  Bullet + solid organ generally results in the organ being fractured or shattered, followed by exsanguination.  If a surgeon is there to open you up, you might do OK... but people still die of those injuries, even in trauma centers.  You can lose a kidney and survive... you can lose your spleen and survive... you can even lose a lobe of your liver and survive (but you CANNOT lose the whole liver).

Antibiotics might help a bit, but you're still going to need a surgeon.

As for antibiotic coverage, you have to hit gram-negatives, gram-positive enteroccci, and anaerobes... so use roughly the same recipe you'd use for diverticulitis:  cipro, amoxicillin, and flagyl.

Thank you again for the detailed response. It is appreciated.

I haven't looked lately, but a few years ago the military's tactical combat casualty care guidelines rec'd two antibiotics
- Tequin (gatifloxicin, a fluoroquinolone) for those who could take oral meds (mostly non-gut wounds)
- Mefoxin (cefoxitin, a 2nd gen cephalosporin) for those who could only get IV meds (mostly gut wounds)
Tequin was in the pill packs handed out with individual first aid kits, which I think also included some Tylenol and Celebrex for pain.

Tequin's off the market now, but Levaquin (levofloxacin) has more or less equivalent coverage.

But like TheGrayMan says, these were intended to be temporizing measures to reduce mortality in the event that casevac to surgery was delayed.  Combat, weather, terrain, etc can screw with transport times.  Absent surgery for penetrating abdominal trauma, you may get lucky and wall off an abscess ... for a while ...