If you had to pick one antibiotic...

[Visionz]

Both good points. For me any reason NOT to take medication is a good reason. If you can fix the problem with a better health regimen, try that first.
It drives me nuts when I see people take BP medication and are 100lbs overweight.
I am probably not one to talk. I smoke. Plan on quitting tomorrow, as I start a rather long vacation away from society. Last checkup I had a year ago I had great lung function, ekg, cholesterol, blood sugar, blood pressure, thyroid. The doctor was actually surprised at how healthy I was for a slightly overweight smoker. Still, I know I am on borrowed time with the cigs and for some reason I gained weight smoking them and last time I quit for six months I dropped 30 pounds. Dont ask me why, just wish me luck on my next attempt.

Anyway... back to the subject.
Since I work at a pharmacy and I am one of very few people who could access the pharmacy. (1 1/2" thick bullet proof glass and a 2" thick steel door will make it hard to loot. If the SHTF ever (and I mean serious lawless SHTF stuff) It's good to know I have access to many kinds.

[GunsUp]

Visionz, don't over-estimate the security of that place... it's only made to stop people from shooting the attendants or getting in for the few minutes it takes the cops to come. There is a good chance the walls are cinderblock or some other type of regular construction masonry. 15 minutes or less with a 20 lb sledge, or 30 seconds with a hijacked delivery truck going 45 mph. Don't think for a second that the addicts won't be that smart or take the opportunity, they will.

Not to mention, looting your workplace is still looting if you are not the owner. It's only a small step up from the "when the world ends I'm going to walmart" mentality. Therefore, you shouldn't mention it on the board.

[GunsUp]

On a good note:
I found some good information on recommended antibiotic treatments for different things:
http://www.cdc.gov/
http://www.guideline.gov/

On a bad note:
Comparing this with the FDA approved prescribing information, it seems that a lot of FDA approved treatments are no longer recommended due to antibiotic resistance, while a lot of off-label uses seem to be first or second line treatments.... It seems for about half the serious infections, I can only find consistent recommendations for IV drugs (which I am not willing to mess with) or hard to acquire drugs like Moxifloxacin, Levofloxacin and rifampin....
this is giving me a headache.

My plan:
I currently have 2 z-packs, 28 TMP-SMZ DS, 90 cephalexin, 20 amox-clav that I have gotten prescribed over the last 4 years and not taken... but the bactrim and z-packs are getting kinda old and I am trying to figure out what to try and acquire.

The ranger medic handbook recommends moxifloxacin, TMP-SMZ, Clindamycin, Ciprofloxacin, and Azithromycin.

The field guide to wilderness medicine (Auerbach) recommends Azithrmycin for respiratory, cephalexin and TMP-SMZ for skin infections and wounds, Cipro for gastrointestinal infections and UTI's.

Seems like Azithromycin, TMP-SMZ and cipro would be a good set for treating most things, maybe throw in a course of Metronidazole for the diarrhea you just cant shake... that is until you read about how everything is resistant to cipro and TMP-SMZ is going to kill you... lol...

I am just babbling with my fingers at this point because I have spent all my spare time for the last 5 days reading about infectious diseases and antibiotics... feel free to jump in and agree, or jump in and tell me I'm stupid, or jump in and tell me to shut-up...

[dallas]

On a good note:
I found some good information on recommended antibiotic treatments for different things:
http://www.cdc.gov/
http://www.guideline.gov/

On a bad note:
Comparing this with the FDA approved prescribing information, it seems that a lot of FDA approved treatments are no longer recommended due to antibiotic resistance, while a lot of off-label uses seem to be first or second line treatments.... It seems for about half the serious infections, I can only find consistent recommendations for IV drugs (which I am not willing to mess with) or hard to acquire drugs like Moxifloxacin, Levofloxacin and rifampin....
this is giving me a headache.

My plan:
I currently have 2 z-packs, 28 TMP-SMZ DS, 90 cephalexin, 20 amox-clav that I have gotten prescribed over the last 4 years and not taken... but the bactrim and z-packs are getting kinda old and I am trying to figure out what to try and acquire.

The ranger medic handbook recommends moxifloxacin, TMP-SMZ, Clindamycin, Ciprofloxacin, and Azithromycin.

The field guide to wilderness medicine (Auerbach) recommends Azithrmycin for respiratory, cephalexin and TMP-SMZ for skin infections and wounds, Cipro for gastrointestinal infections and UTI's.

Seems like Azithromycin, TMP-SMZ and cipro would be a good set for treating most things, maybe throw in a course of Metronidazole for the diarrhea you just cant shake... that is until you read about how everything is resistant to cipro and TMP-SMZ is going to kill you... lol...

I am just babbling with my fingers at this point because I have spent all my spare time for the last 5 days reading about infectious diseases and antibiotics... feel free to jump in and agree, or jump in and tell me I'm stupid, or jump in and tell me to shut-up...

I am glad you have been studying. That is why I posted the links. I hope you can see why things are so complicated. Bugs change and our knowledge changes all the time. We must continually adapt. Even the guidelines.gov stuff can be outdated at times in rapidly changing fields. There is always a lag in knowledge and practice.

You are on the right track, but the risks from TMP-SMZ aren't that bad. The percentage of fatal side effects is very small, but that is one of the reasons you should only use drugs when you really need them. The chance of doing good must greatly outway the chance of doing harm.

Keep studying the solid science based sites and you should learn enough to get you by in a true EOTWAWKI. Are at least as good as anyone can do.

[duodecima]

[I am just babbling with my fingers at this point because I have spent all my spare time for the last 5 days reading about infectious diseases and antibiotics... feel free to jump in and agree, or jump in and tell me I'm stupid, or jump in and tell me to shut-up...

Nope, not stupid! It's that complicated.

I second the "don't worry a lot" about TMP/SMX - I have absolutely seen side effects from it - but over more than a decade none of them have been serious. Being aware of side effects when deciding if the benefits of antibiotics outweigh the risks in a given case is absolutely necessary - but many times the benefits do outweigh the risks.

[Liff]

This thread just turned awesome. Thank you GunsUp.

Just to keep everything in the proper perspective, http://www.fda.gov/ohrms/dockets/ac/03/ ... beling.pdf Read from page 4 to 6. That is just for aspirin. Then there is chronic vs acute side effects, and from there it gets complicated.

[dallas]

Some more reading.
http://www.pidsphil.org/pdf/2011/11Lec- ... herapy.pdf
http://www.jdwnrh.gov.bt/wp-content/upl ... C-2011.pdf
http://ceaccp.oxfordjournals.org/conten ... 84.extract
http://users.ipfw.edu/blumenth/PharmWeb/Antibiotics.PDF

[ptAltered]

Why does no one ask, "What is the best blood pressure medicine I should stock for the paw?" Or, "Which corticosteroid should I have on hand?" Or even, "Which Type II diabetes medicine should I keep around, just in case?" Or an even smarter question, "Which inhaler lasts the longest?"

There is something about the desire to stock up on antibacterial medicine, "just in case". I don't understand it. Ask Dallas, abelru, me, or anyone else who has some formal pharmacology training and some formal infectious disease training and we don't think it is a great idea. Too many variables, and basic hygiene is a much, much better place to start.

So yeah, I don't understand the desire to acquire antibiotics. Maybe it is books and movies? Like in TWD: gun shot + antibiotics = no problem ? I don't know, but I do know that I am never going to be able to convince anyone to not do it, I just hope I can convince people to try to not hurt themselves, or others.

Because people can get fucking shot or otherwise perforated in the PAW.

http://www.ems1.com/medical-clinical/ar ... vironment/

http://www.socnet.com/showthread.php?t=80929

[Doctorr Fabulous]

Because people can get fucking shot or otherwise perforated in the PAW.

http://www.ems1.com/medical-clinical/ar ... vironment/

http://www.socnet.com/showthread.php?t=80929

Not all GSWs require antibiotics. Liff's point was that the prep community seems to flock to antibiotics like geese to water, while (mostly) ignoring or failing to leanr basic trauma care and hygiene. It's one thing to get meds to support a trained provider but it's another to stock up on meds, download a PDF or books, and call it good as is normally the case.

Medicine is one of those things that requires training to use. No prepper in their right mind would buy an AR and ten cases of ammo, throw it in the safe and call it good, but there seems to be a desire to buy antibiotics and store them in (hopefully) a cool, dry place without really knowing the full spectrum of treatment for the drug.

[ptAltered]

Not all GSWs require antibiotics. Liff's point was that the prep community seems to flock to antibiotics like geese to water, while (mostly) ignoring or failing to leanr basic trauma care and hygiene. It's one thing to get meds to support a trained provider but it's another to stock up on meds, download a PDF or books, and call it good as is normally the case.

Valid point. Antibiotics are one of the few drugs that can be administered in an acute setting to save someones life. Insulin, the whole range of ACLS goodies, any other very long term-use medicine just won't last in the PAW. As in One Second After, we'll have to accept that a lot of people with chronic conditions will simply die once their drugs are no longer available. Antibiotics don't fall, necessarily, into that category.

Medicine is one of those things that requires training to use. No prepper in their right mind would buy an AR and ten cases of ammo, throw it in the safe and call it good, but there seems to be a desire to buy antibiotics and store them in (hopefully) a cool, dry place without really knowing the full spectrum of treatment for the drug.

Ironically, I can obtain instruction from thousands (hundreds of thousands?) of competent individuals that'll show me how to use a rifle, but if I want to learn how to use antibiotics it's an eight year process. Most people just don't have the time and, while antibiotic misuse is a huge issue, i'd rather have it and not need it, etc.

Compare the number of people here with antibiotics, which really can't HURT anything too bad (sensitivities and allergies not with standing) compared to the number of people that have decompression needles to dart a chest. Darting a chest, in and of itself, is't that hard of a skill. Recognizing a pneumo that needs decompression and making sure you don't hit any serious vessels is much more difficult, in my opinion, than saying that a guy taking a rusty nail to the hip needs some antibiotics.

HTH

[dallas]

"Ironically, I can obtain instruction from thousands (hundreds of thousands?) of competent individuals that'll show me how to use a rifle, but if I want to learn how to use antibiotics it's an eight year process. Most people just don't have the time and, while antibiotic misuse is a huge issue, i'd rather have it and not need it, etc."

I am trying to help anyone that wants to learn, learn in a lot less than 8 years, but they should read the links I post then ask questions.

"antibiotics, which really can't HURT anything too bad"

That is the mentality that has created all our super bugs. What about C. Diff and so on? Sometimes there can be serious adverse events.

"Recognizing a pneumo that needs decompression and making sure you don't hit any serious vessels is much more difficult, in my opinion, than saying that a guy taking a rusty nail to the hip needs some antibiotics."

Maybe, but what organisms are you going to cover? What about tetanus?

[ptAltered]

I am trying to help anyone that wants to learn, learn in a lot less than 8 years, but they should read the links I post then ask questions.

OK, what's your one pick antibiotic?

"antibiotics, which really can't HURT anything too bad"

That is the mentality that has created all our super bugs. What about C. Diff and so on? Sometimes there can be serious adverse events.

That's the OVER or MIS use of antibiotics.

Maybe, but what organisms are you going to cover? What about tetanus?

None, I don't stock antibiotics. I haven't taken them in a decade, minus a tetanus shot every time I poke myself on something questionable, and don't want to deal with the side effects, specifically allergic reaction, in a PAW.

[GunsUp]

OK, what's your one pick antibiotic?

That's 99% of the problem they have with this thread. There is no "one pick" antibiotic if you don't have the knowledge to know when to use it and when not to use it. You can pick one antibiotic that is going to work for a handful of likely illnesses, but if you take that antibiotic for some other illness it can make you worse off than you started. You have to know a lot more than "If I take an antibiotic, I will get better."

Read back on the last page where I asked about antibiotics for wounds. If you phrase a question with very specific information, indicate a base level of knowledge and ask what antibiotic to pick, you get solid answers. But if you don't know how to clean and care for that wound, the infection will just come back (assuming you even took the right dose of the antibiotic to begin with).

I like the gun analogy. If your grandmother came to you and asked you want handgun to get, and you 100% knew she was never going to bother learning the 4 rules of gun safety, much less practice with it, what would you tell her? What your asking them to do is the equivalent of telling her "get a .45, because they have the most stopping power".

You can get enough medical knowledge to take care of a basic wound on the timescale it takes to learn to handle a gun safely (a weekend wilderness first aid course). You can get a rough idea of when to use (and when not to use) a couple of common antibiotics in roughly the time it takes to become good enough at handling a gun that you have more than a 50/50 chance of defending yourself with it (a week of studying and asking good questions). Nobody is going to take the time to write a weeks worth of knowledge or even a weekends worth on a forum.

Now to liff's original comment about not seeing why preppers would want antibiotics and not anti-hypertensives, it seems obvious to me that most people with hypertension can survive a pretty long time without meds (especially if the hypertension is not pre-existing to the PAW), but somebody who needs antibiotics is in trouble quick. I imagine he recognizes this also, but was probably just flustered by what I am describing above.

Liff: as a side note to one of your suggested questions, is there an alternative to albuterol inhalers (for asthma) that has a better shelf life or temperature stability?

[Liff]

Liff: as a side note to one of your suggested questions, is there an alternative to albuterol inhalers (for asthma) that has a better shelf life or temperature stability?

Way, way off topic for this thread. PM inbound.

[dallas]

OK, what's your one pick antibiotic?

Why do you insist on asking a question that can not be answered? One antibiotic can not do everything.

Because of the national health service, the UK is the best place to find published guidelines, rules, for how you practice. What antibiotic can you find that treats everything well. Look through these links and tell me if you find one.

http://www.medicinesmanagementstoke.nhs ... .0web2.pdf

http://almostadoctor.co.uk/content/syst ... guidelines

http://www.hpsc.ie/hpsc/A-Z/Microbiolog ... 334,en.pdf

[PotatoMuncher]

Liff: as a side note to one of your suggested questions, is there an alternative to albuterol inhalers (for asthma) that has a better shelf life or temperature stability?

Way, way off topic for this thread. PM inbound.

Im interested in that answer as well. Mind PM'ing me?

[ptAltered]

OK, what's your one pick antibiotic?

Why do you insist on asking a question that can not be answered? One antibiotic can not do everything.

Neither can one gun, but how many threads do we have on that?


I'm done in the "First Aid" category for a while, I hope everyone enjoys being told how to avoid helping yourself with the PAW comes.

[dallas]

I hope everyone enjoys being told how to avoid helping yourself with the PAW comes.

Where do you get that? I posted the guidelines from the UK NHS. It is very simple. When you have this, do this. I covers most common cases where you need antibiotics. If that does not help you learn how to treat things in a PAW nothing will.

I am doing my best to help others with good solid data. You just have to read it.

[Doctorr Fabulous]

OK, what's your one pick antibiotic?

Why do you insist on asking a question that can not be answered? One antibiotic can not do everything.

Neither can one gun, but how many threads do we have on that?


I'm done in the "First Aid" category for a while, I hope everyone enjoys being told how to avoid helping yourself with the PAW comes.

For everyone playing at home, please note that there is not a single firearms thread in which there is a consensus of a one-size fits-all rifle. Same goes for blades, packs, food preps...

Medicine just seems to generate more heat recently.

[LowKey]

Medicine just seems to generate more heat recently.

This forum has been generating heat since the day the first layman asked about procedures beyond the scope of Red Cross FA training.*
What's been so nice in the past few years is laymen who ask such questions generally get useful replies, for which those in the medical fields who participate here deserve a very large thank you.


*(and similar courses)

[Jamie]

I get one (sometimes two) wicked sinus infections each winter...could be dry workplace air, snotty kids, hot/cold extremes, no daylight, not enough sleep...who knows, but I get similar bacterial infections every year...untreated, it gets worse, and I lose my voice and have gotten pneumonia from aspirated snot/crap...I know, because I've tried to wait, or tough, it out...

The good news is that amoxicillin kills it dead every time with a simple series...knowing this, if I had to pick one besides the vodka and triple antibiotic ointment I mentioned way back on the first page, I'd go with amoxicillin, because I know that I'm susceptible to this kind of infection, and that amoxicillin kills it for me.

Jamie


Sent from my iPad by the power of bacon.

[Drunkengunner]

Seeing as how I have quite the stockpile after returning from Afghanistan, I'm going to have to say Doxycycline for all of my broad spectrum antibiotic needs.

[Doctorr Fabulous]

Seeing as how I have quite the stockpile after returning from Afghanistan, I'm going to have to say Doxycycline for all of my broad spectrum antibiotic needs.

[ineffableone]

As others have mentioned though this thread just one antibiotic is poor planning. Different ones do different things, and work for different problems. Plus the issue of oral or topical? For me if dealing with just one, as the OP set up, I would say topical is the way to go for a just one situation. The main issues your likely going to have to deal with are issues with wounds needing antibiotics rather than illnesses needing them in PAW. Though of course illness will become an issue especially as sanitation dwindles.

For me the one antibiotic I would go with is one I already pack and do so because it is light weight multi function and has more than antibiotic uses.

It is Pottasium Permanganate

This one substance can be used for water purification, as an antibiotic, and to start a fire with glycerine or antifreeze or with sugar.

A decent video explaining some of the many uses of
Pottasium Permanganate: Water purification, first aid and fire starter


For me something that has so many uses justifies it's place in my pack, especially since they are all such valuable uses. While antibiotics are not something you will regularly use and need hopefully, water purification and fire is something you do need quite regularly. While Pottasium Permanganate is not my primary for these it is a very useful back up, and it being a back up for these helps me save it for it's antibiotic use.

While other antibiotics are a good idea to pack and keep they are generally one purpose only, which is what makes PP a great multi use antibiotic to carry.