If you had to pick one antibiotic...

[Night Errant]

...to have on hand post-shtf, what is it and why? Discuss.

[Doctorr Fabulous]

Oral? Topical? What?

Pick one? Betadyne. Could be used to purify water, simple to use, topically applied, and stores for a long time. Sort of a workhorse antibiotic.

That, or ethanol, because it serves double duty as well.

[elektrik]

Opt for eye ointment erotromitsin, heals all, any inflammation, the eye heals, heals boils, sores, inflammation of the nose, the mouth heals.

ru
Выбираю глазная мазь эротромицин, лечит все, любые воспаления, глаза лечит, фурункулы лечит, гнойные раны, воспаления в носу, в полости рта лечит.

[Night Errant]

Oral? Topical? What?

Pick one? Betadyne. Could be used to purify water, simple to use, topically applied, and stores for a long time. Sort of a workhorse antibiotic.

That, or ethanol, because it serves double duty as well.

Oral, pill type, I mean.

[Doctorr Fabulous]

Opt for eye ointment erotromitsin, heals all, any inflammation, the eye heals, heals boils, sores, inflammation of the nose, the mouth heals.

ru
Выбираю глазная мазь эротромицин, лечит все, любые воспаления, глаза лечит, фурункулы лечит, гнойные раны, воспаления в носу, в полости рта лечит.

Erythromycin (I've seen 4 different spelling now, three of them apparently medically correct, not hating) is a penicillin replacement about on par with amoxicillin (I'm about to give up on spelling these bitches) and would be a solid choice as a general. Can't use it for water, or for "anesthetic" the way you can use iodine or a good vodka, but then again neither of those has as wide a range of medical use as the fungal antibacterials.

FAKE EDIT: Now that I see it's to be an oral, I'm going with penicillin so people don't try to steal my stash because it has a wide range of use, and I'm not allergic to it.

[painiac]

Augmentin: it's a very good broad-spectrum combination of amoxycillin and clavulanic acid.
That or Cipro.

[Jamie]

Probably cheap vodka, amoxicillin/augmentin, and triple antibiotic ointment...with those three, I'd happily wander the PAW with some degree of confidence.

Jamie


Sent from my iPad by the power of Greyskull!

[Doctorr Fabulous]

Ah, vodka. Antibiotic that gives me courage to eat with my work knife, and antiseptic that gives me courage to hit on people while wearing a speedo.

To Popov!

[IANMCDEVITT]

If you only had one antibiotic ? you have very few of your bases covered. Why don't you wait and hope one of the pharmacists chime in. They'll explain it a little better as I am not a pharmacist. BTW Doc Torr, dude, search "Erwinia". I believe it starts to grow in Betadine once you open it. I probably spelled it wrong and pronounced it wrong but we learned about it during nursing school. About the eye ointment? again, once you crack that tube and use it on that one patient, you cannot cross-contaminate. Bad idea to have only one tube of it. I think our thread starter should elaborate a little better to get more accurate answers.

[Nickthezombiehunter]

Keeping it at pick one is very hard for me. Different classes of antibiotics have different methods of actions and indications. If I had my way I would have two at the minimum. First being a gen3 or higher Cephalosporin and second being a Penecillin class.

N

[JIM]

Zithromax. That's what I have in my FAK.

[Liff]

One antibiotic, oral type? A good water filter.

All the antibacterial medicines in the world are not going to do a damned bit of good if you are drinking contaminated water.

Ok then, after a good water filter what would I recommend? Soap. Again, if you can't clean yourself and your equipment, what good are oral antibacterials? And handwashing is the single most important thing (after clean water) you can do to avoid becoming sick.

All right then, after a good water filter and after a supply of soap, what would I recommend? Antibiotic vs antibacterial. Metronidazole kills just about everything including protozoa and amoebas. Fucking noobs recommending penicillins and cephalosporins. lulz.

Other good choices: Levaquin or azithromycin. These two have the spectrum of activity for just about every other bacterial infection and are still good choices for empiric therapy. Of these two, I would prefer the azithromycin. (No Levaquin/fluroquinolones for children also.)

Topical antibiotic? Fuck yes on the Betadine recommendation. I do not care about bacteria that are non-pathogenic to humans (Erwinia). And I could not find anything about this species being able to "grow" in betadine. If you have a link, I would appreciate it.

Seriously though:
1) Water filter.
2) Soap.
3) Worry about something else.
4) Some antibiotics just don't work against some microbiota, or don't work depending on the site of infection, or don't work because the duration was too short, or don't work due to lack of patient compliance, and so on. Sometimes regular penicilllin is the best choice, sometimes it is the worst choice. It all depends. And what about when there is an adverse reaction to the antibiotic and you need the ER?


Asking this question is just like asking, "What one tool do would I need to rebuild an engine?" You could answer a crescent wrench, but what are you going to do when you need a screwdriver?

Fake edit: Jim posted while I was typing. Big plus 1 to Jim from Liff.

[wee drop o' bush]

I try to keep at least one spare course of Cefalexin. I'm prone to various infections due to diabetes & Cefalexin is my antibacterial of choice.

[CipherNameRaVeN]

Opt for eye ointment erotromitsin, heals all, any inflammation, the eye heals, heals boils, sores, inflammation of the nose, the mouth heals.

ru
Выбираю глазная мазь эротромицин, лечит все, любые воспаления, глаза лечит, фурункулы лечит, гнойные раны, воспаления в носу, в полости рта лечит.

I believe it is spelled Eritromicin. Looks it is mostly popular is Eastern Europe.

[duodecima]

If you only had one antibiotic ? you have very few of your bases covered.

This. If I only had one antibiotic, I would be very frustrated/depressed. There's overlap, but there are real reasons there are several classes of antibiotics in common use. If I really, truly could only have one I'd probably go with a 3rd gen quinolone (eg levofloxacin), which has pretty broad utility and good oral bioavalability. But - for any given infection type, there are commonly things as good or better than levofloxacin.

However, if you're in a situation where you know what the most common infection types or infectious agents are going to be (3rd world-style contaminated water? Biowarfare agents? Wound infection? Secondary pneumonias after pandemic influenza?), you can make a much better choice. If you know the local antibiotic resistance patterns, you can make a much better choice - and rates of different types of antibiotic resistance vary significantly between different communities and locations.

Bottom line, antibiotic selection and use is complicated.

Fake edit - Oh, good, Liff stopped by! What he said...

(I feel compelled to add that erythromycin has significant differences in coverage from amoxicillin...)

[kbilly84]

Awesomness

Dammit Liff. I was typing something along those lines.

Only thing I can add:
Drug resistance bacteria. Even if a person found that one, all-awesome antibiotic, what happens when the bacteria become resistant to that antibiotic?

ETA: Crap. Duodecmia beat me to it...

[Liff]

Dammit Liff. I was typing something along those lines.

Only thing I can add:
Drug resistance bacteria. Even if a person found that one, all-awesome antibiotic, what happens when the bacteria become resistant to that antibiotic?

ETA: Crap. Duodecmia beat me to it...

Dammit, I forgot the whole resistance issue as well.

10 years ago the recommendations would be slightly different, and 10 years from now the recommendations are going to be different again. Great point.


Also, I should have wrote: Added text in green.

...Fucking noobs recommending penicillins and cephalosporins as a "The One" antibiotic. lulz. ....

Like I said in my first post, sometimes those are indeed the best choice. But not as "The One" antibiotic.

[Terminus est]

Keep in mind some antibiotics will do more harm than good if used past their best by date.
So if anyone plans on stocking up do some research.

[abelru]

Purell

Lots of Purell

[Doctorr Fabulous]

BTW Doc Torr, dude, search "Erwinia". I believe it starts to grow in Betadine once you open it.

Appreciate it. This is why basic field medicine is not going to be the end of my medical training. I usually carry my betadyne in individual sealed containers. Does Iodine have the same risks? Can iodine be harvested for purification and topical antiseptic use from seafood or other "natural" sources?

[dallas]

This question really has no value. As Liff pointed out, you can not work on a car with only one wrench. You need different sizes.

For example, quinolones and Azithromycin are not good against MRSA here.

Quinolones can also cause tendon ruptures. My orthopod friend does at least a couple of tendon repairs a week from it. He does not think it is rare. Azithromycin can also cause fatal heart attacks as can erythromycin.

As others have pointed out, prevention is critical. There is no magic bullet. I teach my students to identify the most likely causative agent and prescribe for it.

[Vicarious_Lee]

First pick is Levaquin. Broad-Spectrum, excellent bioavailability, and even gets into abscesses somewhat. Next is metronidazole, for reasons Liff said.

In fact, that combination taken orally would be pretty romper stomper on nearly anything.

[Dawgboy]

I have 4 Z-pacs on hand right now. I am susceptible to upper Respiratory infections and Azithromyicin does the job better than anything. Plus, it's easy to buy in Tijuana... Which is perfectly legal as long as you have a doctor's script.
I also have some Augmentin around...

[dallas]

First pick is Levaquin. Broad-Spectrum, excellent bioavailability, and even gets into abscesses somewhat. Next is metronidazole, for reasons Liff said.

In fact, that combination taken orally would be pretty romper stomper on nearly anything.

Would it be your pick for MRSA? Where I work, all soft tissue infections are presumed to be MRSA.