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Originally Posted By TheGrayMan: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By cool_story_bro: Some great info in this thread, thanks. I'm wondering about topical antibiotics- is good old Neosporin enough? Is there a size or depth or type of wound (like burns) that would cause you to not mess around with it? Neosporin doesn't penetrate much; none of the topicals do. This means they don't give you systemic absorption. They're completely inadequate for cellulitis, and deeper tissue infections. They do seem to help some common cuts heal, but you don't have to go nuts with them. They're good for impetigo, and to help heal some minor wound infections, but actual sterile/clean wounds (or wounds that aren't contaminated, and have been properly cleaned/sutured in the appropriate time frame) don't benefit much from antibiotic goop, if at all. Also, given my choice, I'd take Bacitracin or Bactroban over Neosporin. The Neomycin ingredient in Neosporin can be sensitizing/irritating, and people are more likely to end up allergic to it (this is a minor point... use what you have). Is a combination of a systematic antibiotic and a topical antibiotic ever indicated, or is it a "one or the other" thing? If you need systemic treatment, you're past the point where topicals would be very useful. I was thinking more as a prophylactic measure following an injury. Makes no difference in a clean wound... might help in a mildly-infected one... will NOT help in a cellulitic/abscessed wound. ETA: sorry Justin... we cross-posted there. To answer your question, yes... ophthalmic antibiotics would be an excellent addition, particularly if you're in a dry/dusty area. When I was deployed to the sandbox, we treated a lot of eye injuries; mostly corneal abrasions and corneal ulcers. It's simply a consequence of the dust and constant wind... and you can't wear those "rat patrol" goggles all the time. In that vein, most of your eye infections are going to be gram-positive infections... like Staph and such (this changes if you're a contact-lens wearer... many of those are gram-negatives, like Pseudomonas). One also has to take into account what you're treating... simple conjunctivitis, versus a corneal abrasion, versus a full-on corneal ulcer. Sulfa: sulfa is good, and covers Staph, but stings when you put it in... so I don't prescribe much of it. If a patient won't use it (because it's painful), there's no sense in prescribing it. Erythromycin: macrolide that comes in an ointment. I end up using more of this than the Sulfa, just because patients tolerate it better... but it's not recommended for corneal ulcers. It does, however, cover Chlamydia in the eye (yeah...) Cipro/floxin/moxi/Levaquin drops: These are used for the contact-lens wearer, and for corneal ulcers. They're also EXPENSIVE... but for actual corneal ulcers, you'd better use the big guns. You only get one set of eyes. Any idea as to the shelf life of opthalmic ointments and drops? |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By BushBoar:
Any idea as to the shelf life of opthalmic ointments and drops? Couldn't tell you... but I'd ask before I dropped the money. The ophthalmic quinolones (like occuflox, ciloxan, vigamox, etc) are VERY expensive... before going generic, Ciloxan (cipro) was >$100 for a little bottle. Now it's $20-30 for that same bottle. I'll bet it doesn't keep very long... but that would be a better question for a pharmacist. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
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Originally Posted By TheGrayMan:
If you're asking about a minimalist set of drugs to keep for a SHTF scenario, my wish list would be as follows. This is the stuff I'd take myself if I were hiking off into the middle of nowhere... and these are chosen with an eye towards cost savings. Cipro: Great for most gram-negatives (think intestinal flora). Covers invasive diarrheas (salmonella, shigella, E-coli), and UTIs. NOT a good choice for pneumonia, as it has very little gram-positive coverage compared to the "respiratory quinolones" (Levaquin, Avelox, etc). Great oral absorption. Doxycycline: Covers a lot of atypical bugs, including all the Zoonses you're likely to pick up from ticks out in the woods (Lyme, Rocky Mountain Spotted Fever, etc). Also treats Cat Scratch Disease (Cipro also works). Doxy is also an excellent drug for Pneumonia. The only downside is that it makes you photosensitive... so stay out of the sun. Doxycycline Hyclate is also dirt cheap... don't buy the Doxycycline Monohydrate... that's VERY expensive. Amoxicillin: Dirt-cheap gram-positive coverage. Covers strep, and can be a fair choice for sinuses. Will even treat the occasional UTI (though augmentin or ampicillin are probably preferred... the former is very expensive, and the latter is dirt cheap and may be an acceptable substitute for Amoxicillin). Also treats even partially-resistant pneumonias and ear infections in high doses. Flagyl: Covers anaerobes. Several posters have mentioned it being used in conjunction with other antibiotics for Diverticulitis, and they are correct. Levaquin/Flagyl is a common cocktail for Diverticulitis... but your Amoxicillin/Cipro/Flagyl would be acceptable as well. you have to add the Amoxicillin to the Cipro because Cipro lacks the gram-positive coverage of a "respiratory quinolones" like Levaquin.[/span] I used to carry an array of oral antibiotics such as what is outlined above and even a few more from within each category, now I only carry two: Doxycycline (taken once a day for Malaria when in country) This is dirt cheap! Levaquin (if doxy does not knock it down Leva will crush it) This is expensive! I travel and work overseas in a lot of third world suck holes and have used the above two combination with much success. *As a side note: work with your local doctor to get this information first hand, and make sure you actually use some of the antibiotics that you wish to stock in your med pack to find out what your body will tolerate. |
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This thread has been one of the best internet discussions in which I've participated.
The amount of knowledge and communication here has been superb. 
When I originally posted my questions, I never imagined it would go more than one page with several responses. Thanks to all of you who have spent a great deal of time and effort to give us such informed and educated opinions. 
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" Never confuse movement with action." Ernest Hemingway
Protect our 2nd Amendment Rights -- Join the NRA
Protect our 2nd Amendment Rights -- Join the NRA
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I vote for one of my favorites..........
Omnicef (cefdinir). 300mg twice daily for 7 days. YMMV. 
However, there are many others also worthy of selection for a "do-all, be-all, end-all antibiotic". This is just my humble opinion as AR-15.com's very unofficial official pharmacist. |
Sic Semper Tyrannis
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Originally Posted By Rich_V:
Originally Posted By I-N-F-I-D-E-L:
I have cipro and some doxycycline among others....If kept in a cool dry cabnet how long past the exp date are they good for? Double zip lock bag them in the original bottles and placed in your freezer they will last 10 years or more. Do that with doxycycline and it just might kill you. DO NOT EVER take tetracycline-type antibiotics past their expiration dates. Doing so can cause acute kidney failure. 
All other drugs just lose a little potency over time and are safe to take past expiration. |
Sic Semper Tyrannis
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Originally Posted By Stinson342:
Originally Posted By Rich_V:
Originally Posted By I-N-F-I-D-E-L:
I have cipro and some doxycycline among others....If kept in a cool dry cabnet how long past the exp date are they good for? Double zip lock bag them in the original bottles and placed in your freezer they will last 10 years or more. Do that with doxycycline and it just might kill you. DO NOT EVER take tetracycline-type antibiotics past their expiration dates. Doing so can cause acute kidney failure.
All other drugs just lose a little potency over time and are safe to take past expiration. Stored at in a freezer you will extend the life at least 5x the room temp expiration date. As an aside, have you ever looked up the primary literature on tetracycline toxicity from decomposition? |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Originally Posted By CAsoldier:
is there a good online pharmacy where one could buy the listed perscription medication and not be scammed? and a big thanks to all who have posted, ive learned quite a lot! Yes, it is called Amazon. 800mg Sulfamethoxazole and 160mg Trimethoprim 250mg Erythromycin 500mg Cephalexin 500mg Metronidazole 500mg Ciprofloxacin 100mg Doxycycline 500mg Amoxicillin 250 mg Metronidazole 250mg Tetracycline I found this book to be a good read also. Adventure Medical Kits A Comprehensive Guide to Wilderness & Travel Medicine |
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Originally Posted By smokenruger:
Has anyone that's ordered these meds opened the bottles to compare the pills/capsules to known examples from a prescription? If anyone's opened a bottle can they post a pic of that the tablets look like for visual identification and comparison? Did you read this thread before asking your question? |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Originally Posted By speed41ae: Originally Posted By CAsoldier: is there a good online pharmacy where one could buy the listed perscription medication and not be scammed? and a big thanks to all who have posted, ive learned quite a lot! Yes, it is called Amazon. 800mg Sulfamethoxazole and 160mg Trimethoprim 250mg Erythromycin 500mg Cephalexin 500mg Metronidazole 500mg Ciprofloxacin 100mg Doxycycline 500mg Amoxicillin 250 mg Metronidazole 250mg Tetracycline I found this book to be a good read also. Adventure Medical Kits A Comprehensive Guide to Wilderness & Travel Medicine Significantly more expensive than ADC... I can get 60 Sulfa/Trimeth for $3 at ADC vs. $20 at Amazon. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By Rich_V:
Originally Posted By smokenruger:
Has anyone that's ordered these meds opened the bottles to compare the pills/capsules to known examples from a prescription? If anyone's opened a bottle can they post a pic of that the tablets look like for visual identification and comparison? Did you read this thread before asking your question? I read that a couple people say that they have taken them. I may have missed that someone did a real life comparison to pills that they've got from a prescription. And no I haven't seen any pictures posted of pills received, but it's also taken me 2 days to get through the entire thread. I dont get much continuous time infront of the computer. I do appreciate the info that you've contributed to the thread. Thank you, I've found it very helpful in planning. Looking around online and I see the Fish Mox and Fish Mox Forte. Is there any difference in those 2 pills other than dose? The Fish Mox I'm looking at is 250mg/100ct for $15 and the Fish Mox Forte 500mg/100ct for $23 |
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Originally Posted By smokenruger:
Originally Posted By Rich_V:
Originally Posted By smokenruger:
Has anyone that's ordered these meds opened the bottles to compare the pills/capsules to known examples from a prescription? If anyone's opened a bottle can they post a pic of that the tablets look like for visual identification and comparison? Did you read this thread before asking your question? I read that a couple people say that they have taken them. I may have missed that someone did a real life comparison to pills that they've got from a prescription. And no I haven't seen any pictures posted of pills received, but it's also taken me 2 days to get through the entire thread. I dont get much continuous time infront of the computer. I do appreciate the info that you've contributed to the thread. Thank you, I've found it very helpful in planning. Looking around online and I see the Fish Mox and Fish Mox Forte. Is there any difference in those 2 pills other than dose? The Fish Mox I'm looking at is 250mg/100ct for $15 and the Fish Mox Forte 500mg/100ct for $23 My post from page 3 Originally Posted By Rich_V:
OK here is my experience with fish antibiotics. I purchased the following from C&Q management or Thomas labs via Amazon.com Identifying the manufacturer was done by comparing the form provided (capsule or pill) color scheme and markings for each antibiotic by a web search. In each case a photo was found from the manufacturer that matched exactly with what was provided as 'fish antibiotic'. This is not surprising since all of these are now generic and cheap to purchase wholesale. The two sources mentioned simply buy in bulk, repackage and sell direct for use on aquarium fish - perfectly legal under current law. Note all of the dose forms below are those standard for human dosing Tetracycline 250 mg made by Teva Ciprofloxacin 500 mg made by Ranbaxy Doxycycline 100 mg made by West-Ward Cephalexin 500 mg made by West-Ward Metronidazole 250 & 500 mg made by Pliva Erythromycin Sterate 250 mg made by Abbott (enteric coated) Amoxicillin 500 mg made by Davo Bactrim 800 x 160 mg made by Interpharm My fish now live secure in the knowledge that come SHTF they are covered. No photos but they were matched to the manufacturers on line photos. Don't be surprised if what you buy now is from a different drug manufacturer compared to what I purchased, vendors change suppliers to find best supply & price (just like us) |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
| Thanks for pointing that out Rich. Something I'd read yesterday but didn't recall at the time of my post. Any thought on the Mox vs Mox Forte thing? They're both from Thomas Labs and it looks like TL does the same with other products Fish Zole and Fish Zole Forte for example. |
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Originally Posted By smokenruger:
Thanks for pointing that out Rich. Something I'd read yesterday but didn't recall at the time of my post. Any thought on the Mox vs Mox Forte thing? They're both from Thomas Labs and it looks like TL does the same with other products Fish Zole and Fish Zole Forte for example. Reading the descriptions I don't see any difference??? |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Originally Posted By BushBoar: Originally Posted By speed41ae: Originally Posted By CAsoldier: is there a good online pharmacy where one could buy the listed perscription medication and not be scammed? and a big thanks to all who have posted, ive learned quite a lot! Yes, it is called Amazon. 800mg Sulfamethoxazole and 160mg Trimethoprim 250mg Erythromycin 500mg Cephalexin 500mg Metronidazole 500mg Ciprofloxacin 100mg Doxycycline 500mg Amoxicillin 250 mg Metronidazole 250mg Tetracycline I found this book to be a good read also. Adventure Medical Kits A Comprehensive Guide to Wilderness & Travel Medicine Significantly more expensive than ADC... I can get 60 Sulfa/Trimeth for $3 at ADC vs. $20 at Amazon. Difference being on ADC you likely will need to fax/email a prescription to them, per their site. |
Originally Posted By planovet: That song came out in 1969 when I was in jr. high. Back then 2525 seemed a looooooong time away. Shit, now it's only 15 years away.
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Originally Posted By phlat: Originally Posted By BushBoar: Originally Posted By speed41ae: Originally Posted By CAsoldier: is there a good online pharmacy where one could buy the listed perscription medication and not be scammed? and a big thanks to all who have posted, ive learned quite a lot! Yes, it is called Amazon. 800mg Sulfamethoxazole and 160mg Trimethoprim 250mg Erythromycin 500mg Cephalexin 500mg Metronidazole 500mg Ciprofloxacin 100mg Doxycycline 500mg Amoxicillin 250 mg Metronidazole 250mg Tetracycline I found this book to be a good read also. Adventure Medical Kits A Comprehensive Guide to Wilderness & Travel Medicine Significantly more expensive than ADC... I can get 60 Sulfa/Trimeth for $3 at ADC vs. $20 at Amazon. Difference being on ADC you likely will need to fax/email a prescription to them, per their site. You don't need a prescription. I've ordered from them several times without one. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By TheGrayMan: Originally Posted By BushBoar: Any idea as to the shelf life of opthalmic ointments and drops? Couldn't tell you... but I'd ask before I dropped the money. The ophthalmic quinolones (like occuflox, ciloxan, vigamox, etc) are VERY expensive... before going generic, Ciloxan (cipro) was >$100 for a little bottle. Now it's $20-30 for that same bottle. I'll bet it doesn't keep very long... but that would be a better question for a pharmacist. I can get opthalmic FQ pretty cheap ($2.02/3ml for cipro, $2.50/5ml for levo, and $0.83/5ml for oflox), so on my next order from ADC I'll tack a couple on and report as to the expiration dates. If I have ophthalmic FQ, is a macrolide drop or ointment necessary? Could ophthalmic drops be used for in place of otic drops in a pinch? |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
Any idea as to the shelf life of opthalmic ointments and drops? Couldn't tell you... but I'd ask before I dropped the money. The ophthalmic quinolones (like occuflox, ciloxan, vigamox, etc) are VERY expensive... before going generic, Ciloxan (cipro) was >$100 for a little bottle. Now it's $20-30 for that same bottle. I'll bet it doesn't keep very long... but that would be a better question for a pharmacist. I can get opthalmic FQ pretty cheap ($2.02/3ml for cipro, $2.50/5ml for levo, and $0.83/5ml for oflox), so on my next order from ADC I'll tack a couple on and report as to the expiration dates. If I have ophthalmic FQ, is a macrolide drop or ointment necessary? Could ophthalmic drops be used for in place of otic drops in a pinch? If you only have ophthalmic quinolones, you should be GTG... and they most certainly can be used in the ear. The converse on the situation is NOT true, however; DO NOT use otic stuff in the eye. For example, you could use an ophthalmic quinolone drop for a really nasty swimmer's ear...just make sure you pack the ear with some cotton wicking material before you put in the drops. The wick sucks up the antibiotic liquid and keeps it in the ear, where it can contact the inner circumference of the auditory canal. The drops must remain in the ear to work, because if they just run right out, you're no longer getting the antibiotic effect. As long as you keep that wicking material moist with your FQ (a few drops, four times a day), you should get better... but make sure you use a wick. That wick is literally 80% of the treatment. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
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Originally Posted By smokenruger:
Same here. Ingredients are listed as 250mg and 500mg Amoxicillin respectively. I've orderd the 500mg/100ct Mox Forte and 250mg/100ct Fish Zole. I'm still interested if there's a difference so I'll post back if I come up with anything. So I received my order today. These are the pills I received. Fish Mox Forte http://www.drugs.com/imprints/a45-14439.html Fish Zole http://www.drugs.com/imprints/pliva-333-12040.html Very happy and will make an additional order after the holiday shopping is over. |
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Originally Posted By smokenruger:
Originally Posted By smokenruger:
Same here. Ingredients are listed as 250mg and 500mg Amoxicillin respectively. I've orderd the 500mg/100ct Mox Forte and 250mg/100ct Fish Zole. I'm still interested if there's a difference so I'll post back if I come up with anything. So I received my order today. These are the pills I received. Fish Mox Forte http://www.drugs.com/imprints/a45-14439.html Fish Zole http://www.drugs.com/imprints/pliva-333-12040.html Very happy and will make an additional order after the holiday shopping is over. I dare you to swallow one... 
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Originally Posted By TheGrayMan: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By BushBoar: Any idea as to the shelf life of opthalmic ointments and drops? Couldn't tell you... but I'd ask before I dropped the money. The ophthalmic quinolones (like occuflox, ciloxan, vigamox, etc) are VERY expensive... before going generic, Ciloxan (cipro) was >$100 for a little bottle. Now it's $20-30 for that same bottle. I'll bet it doesn't keep very long... but that would be a better question for a pharmacist. I can get opthalmic FQ pretty cheap ($2.02/3ml for cipro, $2.50/5ml for levo, and $0.83/5ml for oflox), so on my next order from ADC I'll tack a couple on and report as to the expiration dates. If I have ophthalmic FQ, is a macrolide drop or ointment necessary? Could ophthalmic drops be used for in place of otic drops in a pinch? If you only have ophthalmic quinolones, you should be GTG... and they most certainly can be used in the ear. The converse on the situation is NOT true, however; DO NOT use otic stuff in the eye. For example, you could use an ophthalmic quinolone drop for a really nasty swimmer's ear...just make sure you pack the ear with some cotton wicking material before you put in the drops. The wick sucks up the antibiotic liquid and keeps it in the ear, where it can contact the inner circumference of the auditory canal. The drops must remain in the ear to work, because if they just run right out, you're no longer getting the antibiotic effect. As long as you keep that wicking material moist with your FQ (a few drops, four times a day), you should get better... but make sure you use a wick. That wick is literally 80% of the treatment. Thanks, now I just have to find a couple packages of wicks to keep in my kit. Another question: I understand that most antivirals are pretty useless for this type of discussion, but do you think that Tamiflu would be worthwhile? It's not cheap but not completely out of the question. I can get it for $80/10 pill pack (75 mg tabs), and as you know 10 pills is the course for therapy (2 pills x 5 days) or prophylaxis (1 pill x 10 days). |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
Any idea as to the shelf life of opthalmic ointments and drops? Couldn't tell you... but I'd ask before I dropped the money. The ophthalmic quinolones (like occuflox, ciloxan, vigamox, etc) are VERY expensive... before going generic, Ciloxan (cipro) was >$100 for a little bottle. Now it's $20-30 for that same bottle. I'll bet it doesn't keep very long... but that would be a better question for a pharmacist. I can get opthalmic FQ pretty cheap ($2.02/3ml for cipro, $2.50/5ml for levo, and $0.83/5ml for oflox), so on my next order from ADC I'll tack a couple on and report as to the expiration dates. If I have ophthalmic FQ, is a macrolide drop or ointment necessary? Could ophthalmic drops be used for in place of otic drops in a pinch? If you only have ophthalmic quinolones, you should be GTG... and they most certainly can be used in the ear. The converse on the situation is NOT true, however; DO NOT use otic stuff in the eye. For example, you could use an ophthalmic quinolone drop for a really nasty swimmer's ear...just make sure you pack the ear with some cotton wicking material before you put in the drops. The wick sucks up the antibiotic liquid and keeps it in the ear, where it can contact the inner circumference of the auditory canal. The drops must remain in the ear to work, because if they just run right out, you're no longer getting the antibiotic effect. As long as you keep that wicking material moist with your FQ (a few drops, four times a day), you should get better... but make sure you use a wick. That wick is literally 80% of the treatment. Thanks, now I just have to find a couple packages of wicks to keep in my kit. Another question: I understand that most antivirals are pretty useless for this type of discussion, but do you think that Tamiflu would be worthwhile? It's not cheap but not completely out of the question. I can get it for $80/10 pill pack (75 mg tabs), and as you know 10 pills is the course for therapy (2 pills x 5 days) or prophylaxis (1 pill x 10 days). Just get a flu shot... much cheaper to prevent than to treat. If you want to keep some for SHTF, that's OK too. As an addendum to the eye-drops-in-the-ear thing, let me add one admonition. Be careful if you've got a perforated drum... mostly they recommend those be kept dry, particularly since certain eye drops (like Gentamycin drops) are straight-up ototoxic, and can leave you deaf. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
Any idea as to the shelf life of opthalmic ointments and drops? Couldn't tell you... but I'd ask before I dropped the money. The ophthalmic quinolones (like occuflox, ciloxan, vigamox, etc) are VERY expensive... before going generic, Ciloxan (cipro) was >$100 for a little bottle. Now it's $20-30 for that same bottle. I'll bet it doesn't keep very long... but that would be a better question for a pharmacist. I can get opthalmic FQ pretty cheap ($2.02/3ml for cipro, $2.50/5ml for levo, and $0.83/5ml for oflox), so on my next order from ADC I'll tack a couple on and report as to the expiration dates. If I have ophthalmic FQ, is a macrolide drop or ointment necessary? Could ophthalmic drops be used for in place of otic drops in a pinch? If you only have ophthalmic quinolones, you should be GTG... and they most certainly can be used in the ear. The converse on the situation is NOT true, however; DO NOT use otic stuff in the eye. For example, you could use an ophthalmic quinolone drop for a really nasty swimmer's ear...just make sure you pack the ear with some cotton wicking material before you put in the drops. The wick sucks up the antibiotic liquid and keeps it in the ear, where it can contact the inner circumference of the auditory canal. The drops must remain in the ear to work, because if they just run right out, you're no longer getting the antibiotic effect. As long as you keep that wicking material moist with your FQ (a few drops, four times a day), you should get better... but make sure you use a wick. That wick is literally 80% of the treatment. Thanks, now I just have to find a couple packages of wicks to keep in my kit. Another question: I understand that most antivirals are pretty useless for this type of discussion, but do you think that Tamiflu would be worthwhile? It's not cheap but not completely out of the question. I can get it for $80/10 pill pack (75 mg tabs), and as you know 10 pills is the course for therapy (2 pills x 5 days) or prophylaxis (1 pill x 10 days). Tamiflu, absolutely! But only for the worst senarios that haven't happened yet. The dosage you quoted is low for the 'worst senarios' and has been revised by the CDC IIRC. Shelf life has been revised a while back to IIRC 10 yrs and I'll bet it's good way beyond if stored with some common sense. Think of it as insurance, sort of like having a survey meter. |
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Originally Posted By TheGrayMan: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By BushBoar: Originally Posted By TheGrayMan: Originally Posted By BushBoar: Any idea as to the shelf life of opthalmic ointments and drops? Couldn't tell you... but I'd ask before I dropped the money. The ophthalmic quinolones (like occuflox, ciloxan, vigamox, etc) are VERY expensive... before going generic, Ciloxan (cipro) was >$100 for a little bottle. Now it's $20-30 for that same bottle. I'll bet it doesn't keep very long... but that would be a better question for a pharmacist. I can get opthalmic FQ pretty cheap ($2.02/3ml for cipro, $2.50/5ml for levo, and $0.83/5ml for oflox), so on my next order from ADC I'll tack a couple on and report as to the expiration dates. If I have ophthalmic FQ, is a macrolide drop or ointment necessary? Could ophthalmic drops be used for in place of otic drops in a pinch? If you only have ophthalmic quinolones, you should be GTG... and they most certainly can be used in the ear. The converse on the situation is NOT true, however; DO NOT use otic stuff in the eye. For example, you could use an ophthalmic quinolone drop for a really nasty swimmer's ear...just make sure you pack the ear with some cotton wicking material before you put in the drops. The wick sucks up the antibiotic liquid and keeps it in the ear, where it can contact the inner circumference of the auditory canal. The drops must remain in the ear to work, because if they just run right out, you're no longer getting the antibiotic effect. As long as you keep that wicking material moist with your FQ (a few drops, four times a day), you should get better... but make sure you use a wick. That wick is literally 80% of the treatment. Thanks, now I just have to find a couple packages of wicks to keep in my kit. Another question: I understand that most antivirals are pretty useless for this type of discussion, but do you think that Tamiflu would be worthwhile? It's not cheap but not completely out of the question. I can get it for $80/10 pill pack (75 mg tabs), and as you know 10 pills is the course for therapy (2 pills x 5 days) or prophylaxis (1 pill x 10 days). Just get a flu shot... much cheaper to prevent than to treat. If you want to keep some for SHTF, that's OK too. As an addendum to the eye-drops-in-the-ear thing, let me add one admonition. Be careful if you've got a perforated drum... mostly they recommend those be kept dry, particularly since certain eye drops (like Gentamycin drops) are straight-up ototoxic, and can leave you deaf. That being the case, can oral ABX be used for all ear infections? Or do some require topicals? |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
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Originally Posted By BushBoar:
That being the case, can oral ABX be used for all ear infections? Or do some require topicals? Sure... they're used all the time for middle ear infections. There are two main types of ear infections: external (the canal up to the drum), and middle (the space behind the drum, containing the little tiny bones). There is also an inner-ear infection, but it's much rarer. The classic "ear infection" that your 2yo gets is a middle-ear infection... while "swimmer's ear" is an external ear infection, usually a result of retained water in the ear breaking down the skin, and allowing skin bacteria to invade. Most middle ear infections are treatable with oral antibiotics, and you're basically wasting your time with topical antibiotics, because they can't get past the tympanic membrane (the ear drum). That said, external ear infections can be treated with topicals, OR oral/systemic antibiotics, but the latter isn't usually necessary (an exception is diabetics and the immunocompromised... they can get a particularly nasty form of swimmers ear called Malignant External Otitis, which can actually be lethal if untreated). |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
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I know they aren't antibiotics, but I don't want to start another thread. Where can a person find epi-pens on the net? I'll talk to my doc next time I see him and get a couple, but I'd like to have them in my supply just in case. I have some friends with some pretty bad allergies and would like to have them for a SHTF situation.
I tried all day chemist, but couldn't find them. |
If I should lose my life, to what better purpose could I give it?
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Originally Posted By stutzcattle: I know they aren't antibiotics, but I don't want to start another thread. Where can a person find epi-pens on the net? I'll talk to my doc next time I see him and get a couple, but I'd like to have them in my supply just in case. I have some friends with some pretty bad allergies and would like to have them for a SHTF situation. I tried all day chemist, but couldn't find them. They have some strange omissions. They sell amikacin and imipenem, which are both uncommon and expensive injectable antibiotics ($8/vial and $32/vial respectively), but they don't sell plain penicillin G, or ampicillin/sulbactim vials. I emailed them asking if they could get some, and they said no. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Question for thegrayman or other medical professionals.
Looking at the various generations of fluoroquinolones, if you have cipro and levofloxacin available are there any real advantages of fourth generation agents like Avelox (moxifloxacin)? Lets ignore the (big) price differential from this question. |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Whoa, there is a substantial price difference between levo and moxi. Good question. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By Rich_V:
Question for thegrayman or other medical professionals. Looking at the various generations of fluoroquinolones, if you have cipro and levofloxacin available are there any real advantages of fourth generation agents like Avelox (moxifloxacin)? Lets ignore the (big) price differential from this question. The major advantage is extended spectrum. Classically, quinolones were used for infections that involved gram negative infections. The best example is probably UTIs, which are E. coli, Proteus, etc. This changed with the advent of extended-spectrum quinolones (also called "respiratory quinolones"). These drugs have bacteriacidal activity into the gram-positive spectrum, with one of the most clinically important being Pneumococcus (Strep. pneumonea). In a clinical nutshell, newer quinolones not only cover UTIs and such, but also pneumonia. Some people use them for refractory sinusitis, but that's often a waste, since other antibiotics can be used instead. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Originally Posted By TheGrayMan:
Originally Posted By Rich_V:
Question for thegrayman or other medical professionals. Looking at the various generations of fluoroquinolones, if you have cipro and levofloxacin available are there any real advantages of fourth generation agents like Avelox (moxifloxacin)? Lets ignore the (big) price differential from this question. The major advantage is extended spectrum. Classically, quinolones were used for infections that involved gram negative infections. The best example is probably UTIs, which are E. coli, Proteus, etc. This changed with the advent of extended-spectrum quinolones (also called "respiratory quinolones"). These drugs have bacteriacidal activity into the gram-positive spectrum, with one of the most clinically important being Pneumococcus (Strep. pneumonea). In a clinical nutshell, newer quinolones not only cover UTIs and such, but also pneumonia. Some people use them for refractory sinusitis, but that's often a waste, since other antibiotics can be used instead. Ok the biggest difference I saw between levofloxacin and moxifloxacin is moxi has better activity on anaerobes but inferior Pseudomonas activity compared to levo. If you did not have culture susceptibility data are there reasons to select one over the other? To clarify, if you could have only one fluoroquinolone which would you pick (price not a factor)? |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Can we talk about dosage for a second.
All this information of what you need and when is great, but without knowing what dosage / treatment regimen to administer, you could potentially do more harm than good. For instance, if you use Levofloxacin as an example, you can see it comes in various dosages What would be a typical course of treatment that you would prescribe for an adult? Which dosage would be the best to buy? How can we find this info for other meds like cipro, Flagyl, etc. etc.? Thanks! |
"The Nation that makes a great distinction between its scholars and its warriors will have its thinking done by cowards and its fighting done by fools." -- Thucydides
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Originally Posted By MK262:
Can we talk about dosage for a second. All this information of what you need and when is great, but without knowing what dosage / treatment regimen to administer, you could potentially do more harm than good. For instance, if you use Levofloxacin as an example, you can see it comes in various dosages What would be a typical course of treatment that you would prescribe for an adult? Which dosage would be the best to buy? How can we find this info for other meds like cipro, Flagyl, etc. etc.? Thanks! Google the specific ABX and look for a manufacturers drug insert doc for example, levaquin http://www.levaquin360.com/levaquin360/full_us_prescribing_information.html |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Originally Posted By TheGrayMan:
Originally Posted By Rich_V:
Question for thegrayman or other medical professionals. Looking at the various generations of fluoroquinolones, if you have cipro and levofloxacin available are there any real advantages of fourth generation agents like Avelox (moxifloxacin)? Lets ignore the (big) price differential from this question. The major advantage is extended spectrum. Classically, quinolones were used for infections that involved gram negative infections. The best example is probably UTIs, which are E. coli, Proteus, etc. This changed with the advent of extended-spectrum quinolones (also called "respiratory quinolones"). These drugs have bacteriacidal activity into the gram-positive spectrum, with one of the most clinically important being Pneumococcus (Strep. pneumonea). In a clinical nutshell, newer quinolones not only cover UTIs and such, but also pneumonia. Some people use them for refractory sinusitis, but that's often a waste, since other antibiotics can be used instead. FYI Avelox is not generally recommended for a complicated UTI. For be if they said one respiratory quinolone it would be levofloxacin over Avelox. That being said you do have to renally adjust Levaquin, were you don't have to adjust with Avelox |
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Originally Posted By Ryerle51:
Originally Posted By TheGrayMan:
Originally Posted By Rich_V:
Question for thegrayman or other medical professionals. Looking at the various generations of fluoroquinolones, if you have cipro and levofloxacin available are there any real advantages of fourth generation agents like Avelox (moxifloxacin)? Lets ignore the (big) price differential from this question. The major advantage is extended spectrum. Classically, quinolones were used for infections that involved gram negative infections. The best example is probably UTIs, which are E. coli, Proteus, etc. This changed with the advent of extended-spectrum quinolones (also called "respiratory quinolones"). These drugs have bacteriacidal activity into the gram-positive spectrum, with one of the most clinically important being Pneumococcus (Strep. pneumonea). In a clinical nutshell, newer quinolones not only cover UTIs and such, but also pneumonia. Some people use them for refractory sinusitis, but that's often a waste, since other antibiotics can be used instead. FYI Avelox is not generally recommended for a complicated UTI. For be if they said one respiratory quinolone it would be levofloxacin over Avelox. That being said you do have to renally adjust Levaquin, were you don't have to adjust with Avelox I would never use Avelox for a UTI anyway... cipro is generic, dirt-cheap, and perfectly adequate... and any organism resistant to cipro will likely be resistant to Avelox as well. Levaquin would be my first choice for a "covers most bases" quinolone. I don't think I've ever written a script for Avelox... A lot of my patients are dirt-poor, so I tend to prescribe cheap. I've also seen some horrific allergic reactions to Avelox, including one lady whose throat I nearly had to cut for angioedema and airway obstruction. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
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Originally Posted By TheGrayMan:
Originally Posted By Ryerle51:
Originally Posted By TheGrayMan:
Originally Posted By Rich_V:
Question for thegrayman or other medical professionals. Looking at the various generations of fluoroquinolones, if you have cipro and levofloxacin available are there any real advantages of fourth generation agents like Avelox (moxifloxacin)? Lets ignore the (big) price differential from this question. The major advantage is extended spectrum. Classically, quinolones were used for infections that involved gram negative infections. The best example is probably UTIs, which are E. coli, Proteus, etc. This changed with the advent of extended-spectrum quinolones (also called "respiratory quinolones"). These drugs have bacteriacidal activity into the gram-positive spectrum, with one of the most clinically important being Pneumococcus (Strep. pneumonea). In a clinical nutshell, newer quinolones not only cover UTIs and such, but also pneumonia. Some people use them for refractory sinusitis, but that's often a waste, since other antibiotics can be used instead. FYI Avelox is not generally recommended for a complicated UTI. For be if they said one respiratory quinolone it would be levofloxacin over Avelox. That being said you do have to renally adjust Levaquin, were you don't have to adjust with Avelox I would never use Avelox for a UTI anyway... cipro is generic, dirt-cheap, and perfectly adequate... and any organism resistant to cipro will likely be resistant to Avelox as well. Levaquin would be my first choice for a "covers most bases" quinolone. I don't think I've ever written a script for Avelox... A lot of my patients are dirt-poor, so I tend to prescribe cheap. I've also seen some horrific allergic reactions to Avelox, including one lady whose throat I nearly had to cut for angioedema and airway obstruction. Just thought I would point out to others since you mentioned Avelox and then mentioned UTIs. You and I realize that Avelox isn't a good choice for UTIs but the general public may not, and I have witnessed MDs trying to use Avelox for UTIs. Just my .02 and I appreciate your insight. |
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Originally Posted By TheGrayMan: Originally Posted By Ryerle51: Originally Posted By TheGrayMan: Originally Posted By Rich_V: Question for thegrayman or other medical professionals. Looking at the various generations of fluoroquinolones, if you have cipro and levofloxacin available are there any real advantages of fourth generation agents like Avelox (moxifloxacin)? Lets ignore the (big) price differential from this question. The major advantage is extended spectrum. Classically, quinolones were used for infections that involved gram negative infections. The best example is probably UTIs, which are E. coli, Proteus, etc. This changed with the advent of extended-spectrum quinolones (also called "respiratory quinolones"). These drugs have bacteriacidal activity into the gram-positive spectrum, with one of the most clinically important being Pneumococcus (Strep. pneumonea). In a clinical nutshell, newer quinolones not only cover UTIs and such, but also pneumonia. Some people use them for refractory sinusitis, but that's often a waste, since other antibiotics can be used instead. FYI Avelox is not generally recommended for a complicated UTI. For be if they said one respiratory quinolone it would be levofloxacin over Avelox. That being said you do have to renally adjust Levaquin, were you don't have to adjust with Avelox I would never use Avelox for a UTI anyway... cipro is generic, dirt-cheap, and perfectly adequate... and any organism resistant to cipro will likely be resistant to Avelox as well. Levaquin would be my first choice for a "covers most bases" quinolone. I don't think I've ever written a script for Avelox... A lot of my patients are dirt-poor, so I tend to prescribe cheap. I've also seen some horrific allergic reactions to Avelox, including one lady whose throat I nearly had to cut for angioedema and airway obstruction. But why use a FQ instead of Macrobid (2x daily dosing v. 4 with straight nitrofurantoin) or TMP/SMX? Don't get me wrong, I've had a couple UTIs and I got cipro and it knocked them out fast and I didn't have any appreciable side effects, but I thought that FQs were supposed to be limited in use. Is resistance to Macrobid and TMP/SMX that common? Just curious, obviously you have the MD and I don't. |
Suos Cultores Scientia Coronat
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
"But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg." - Thomas Jefferson, Notes on the State of Virginia, 1782
|
Originally Posted By BushBoar:
But why use a FQ instead of Macrobid (2x daily dosing v. 4 with straight nitrofurantoin) or TMP/SMX? Don't get me wrong, I've had a couple UTIs and I got cipro and it knocked them out fast and I didn't have any appreciable side effects, but I thought that FQs were supposed to be limited in use. Is resistance to Macrobid and TMP/SMX that common? Just curious, obviously you have the MD and I don't. There isn't a thing wrong with Sulfa. I used a metric sh*t-ton of it (again... it's cheap, and I'm all about cheap). However, there is more resistance to Sulfa than the quinolones. Macrobid is likewise a fine choice... and there's almost no resistance to it in my area. The argument against Nitrofurantoin is that it's theoretically a bit more bacteriostatic than bacteriocidal, and may be inadequate for more severe infections. For simple/minor/uncomplicated UTIs, it's a top contender. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
UTI treatments from Hopkins ABX guide
Bacterial Cystitis, Acute, Uncomplicated PATHOGENS * Bug distribution: (1) E. coli = 80-90%% in outpatients, 18-57% for in-patients. (2) S. saprophyticus= 0-2% in outpatients, much higher in young women. * Uropathogenic E. coli (UPEC) = Subset of extraintestinal E. coli (ExPEC) most likely to cause UTIs are groups B2 and D that have "fitness elements" providing them with advantage in extraintestinal niche. * Uncomplicated UTI, >95% of infections due to single organism. * Other organisms less common and include: other Enterobacteriaceae, P. aeruginosa, Grps B and D streptococci, and enterococci. Rarely H.influenzae, , anaerobes, salmonella, shigella, adenovirus type 11, ureaplasma mycoplasma. * Factors favoring bacterial persistence/colonization and infection: (1) bacterial binding via fimbriae, (2) high growth rates despite high osmolarity and urea concentrations and low pH. * Factors favoring bacterial elimination include: (1) high urine flow rate, (2) frequent voiding, (3) bactericidal effects of secreted proteins, (4) bladder mucosa and (5) inflammatory responses. TREATMENT Short Course Therapy (Empirical Treatment) * Resistance patterns of E. coli to TMP-SMX and the fluoroquinolones are highly variable across U.S. and are continuing to change. Clinicians are strongly urged to recognize resistance patterns in their community. * Nitrofurantoin is encouraged for use (see Longer Duration Therapy below) given rates of TMP-SMX E. coli resistance >10% in all U.S. Regions examined and as a fluoroquinolone-sparing agent for women with mild to moderate symptoms AND allergy to TMP-SMX or prior antibiotic in previous 3 months (except for nitrofurantoin ) or live in a locality with prevalence of E. coli resistance of TMP-SMX >10-20% in women with uncomplicated UTI. * Trimethoprim-sulfamethoxazole DS (Bactrim/Septra) 1 tab PO twice daily x 3d (preferred for empiric Rx if local prevalence of E. coli resistance to TMP-SMX < 10-20%; if > 10-20% use fluoroquinolone) ––- Check with local laboratory for resistance at least once every 6 months. * Trimethoprim 300 mg PO once daily x 3d (do not use if resistance to TMP-SMX is > 10-20%). Check with local laboratory for E. coli resistance rates every 6 months. * TMP-SMX and TMP alone are first line Rx because they are cheap and there is a critical need to reserve FQs for use in complicated UTIs. Overuse in acute cystitis may lead to resistance. * Norfloxacin 400 mg PO twice daily x 3d for women with severe symptoms AND allergy to TMP-SMX or abx Rx in the last 3 months (except a FQ), or live in locality with E. coli resistance >20% in women with acute uncomplicated UTI. * Ciprofloxacin 250 mg PO twice daily x 3d for women with severe symptoms AND allergy to TMP-SMX or abx Rx in the last 3 months (except a FQ), or live in locality with E. coli resistance >20% in women with acute uncomplicated UTI. * Ofloxacin 200 mg PO twice daily x 3d for women with severe symptoms AND allergy to TMP-SMX or abx Rx in the last 3 months (except a FQ), or live in locality with E. coli resistance >20% in women with acute uncomplicated UTI. * Amoxicillin/clavulanate 500/125 mg PO twice daily x 3d (higher percentage of organisms resistant to amoxicillin alone. This regimen is inferior to ciprofloxacin and if amox/clavulanate used, longer duration therapy is indicated (see Longer Duration Therapy) * There is no single dose treatment regimens using fluoroquinolones that are FDA-approved that have equal efficacy to the 3-day regimens in terms of sterilization of urine and recurrence rate. Therefore, single dose regimens are to be avoided. Urinary Tract Infection, Complicated (UTI) PATHOGENS * Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp. are among the most common. Resistant strains frequently encountered. * MRSA, Enterococcus spp. (including VRE), Candida spp. and fastidious organisms possible. * Infections may be polymicrobial, especially if chronic urinary catheter or stents are present. TREATMENT * Empiric therapy must be broad spectrum with definitive therapy based on culture and sensitivity. * If patient mild to moderately ill: levofloxacin (500mg IV/PO q24) or ciprofloxacin (500mg PO twice-daily/400mg q 12h IV) are reasonable empiric choices if patient has not recently received a FQ, is not from a long-term care facility (LTCF), and FQ resistance is low. * If patient severely ill or received recent FQ or from LTCF: select broad empiric coverage with either cefepime 2g IV q12 hrs, ceftazidime 2g IV q8 hrs, imipenem 500 mg IV q 6 hrs, meropenem 1g IV q8 hrs, doripenem 500 mg IV q8 hrs or piperacillin-tazobactam 3.375-4.5g IV q6 hrs (order of preference based on local sensitivity patterns). Note that all of the listed agents must be adjusted for renal insufficiency. * If patient severely ill and urine gram stain shows gram (+) cocci: consider adding vancomycin empirically. * Once culture and sensitivity available, switch to narrow spectrum as much as feasible. * Duration: European guidelines recommend stopping treatment 3 to 5 days after either defervescence or elimination of the complicating factor (e. g., catheter or stone). Shorter courses (7 days) are reasonable if patient improves rapidly. Longer courses (10 to 14 days) are reasonable if patient has a delayed response. |
223 gets the job done, 308 makes a statement, 50 BMG shows an attitude!
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Originally Posted By TheGrayMan:
Just get a flu shot... much cheaper to prevent than to treat. If you want to keep some for SHTF, that's OK too. thats If you believe that the flu shot works as advertised, which i don't buy th hype except in the subpopulations of the very old, very young and with chronic diseases, especially lung diseases. there is too much self selection bias in the original studies to trust the results, and several have shown that the mortality benefit clearly extends to populations outside of the flu season which further highlights the bias inherent to the study. |
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Originally Posted By EXPY37:
Tamiflu, absolutely! But only for the worst senarios that haven't happened yet. The dosage you quoted is low for the 'worst senarios' and has been revised by the CDC IIRC. Shelf life has been revised a while back to IIRC 10 yrs and I'll bet it's good way beyond if stored with some common sense. Think of it as insurance, sort of like having a survey meter. except that (other than h1n1) the common influenza A strains which cause the majority of illness each year tend to be tamiflu resistant. so you'd have to have either relenza or add on amanditdine to the tamiflu. |
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Originally Posted By ipsilateral_7:
Originally Posted By TheGrayMan:
Just get a flu shot... much cheaper to prevent than to treat. If you want to keep some for SHTF, that's OK too. thats If you believe that the flu shot works as advertised, which i don't buy th hype except in the subpopulations of the very old, very young and with chronic diseases, especially lung diseases. there is too much self selection bias in the original studies to trust the results, and several have shown that the mortality benefit clearly extends to populations outside of the flu season which further highlights the bias inherent to the study. *shrug* I always get a flu shot. Feel free to disagree. |
"Look wise, say nothing, and grunt. Speech was given to conceal thought."
- Sir William Osler -
- Sir William Osler -
|
Originally Posted By TheGrayMan:
Originally Posted By BushBoar:
But why use a FQ instead of Macrobid (2x daily dosing v. 4 with straight nitrofurantoin) or TMP/SMX? Don't get me wrong, I've had a couple UTIs and I got cipro and it knocked them out fast and I didn't have any appreciable side effects, but I thought that FQs were supposed to be limited in use. Is resistance to Macrobid and TMP/SMX that common? Just curious, obviously you have the MD and I don't. There isn't a thing wrong with Sulfa. I used a metric sh*t-ton of it (again... it's cheap, and I'm all about cheap). However, there is more resistance to Sulfa than the quinolones. Macrobid is likewise a fine choice... and there's almost no resistance to it in my area. The argument against Nitrofurantoin is that it's theoretically a bit more bacteriostatic than bacteriocidal, and may be inadequate for more severe infections. For simple/minor/uncomplicated UTIs, it's a top contender. FYI my area's latest antibiogram just came out, and the top three urinary tract organisms are < 40 % sensitive to FQs. Things are changing pretty quickly. We lost quinolones for sexually transmitted infections last year or year before. |
Everyman, I will go with thee
and be thy guide,
In thy most need to go
by thy side.
and be thy guide,
In thy most need to go
by thy side.