If you could have only one antibiotic...Redux:

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Dinky
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If you could have only one antibiotic...Redux:

Post by Dinky » Sun Jul 13, 2014 6:32 pm

Folks,

As a new member of the forum, I want to thank everyone in advance for your advice and guidance. As a non-medical person, I have researched the question of antibiotics for disaster preparedness fairly extensively. I have seen the question with which I titled this thread asked on numerous occasions. Always, the answer comes with the following disclaimers and advice, sometimes from Doctors and medics, sometimes from ordinary preppers like you and me:

1. that often (as with viruses) antibiotics are useless.
2. that proper cleanliness and washing of hands will kill many germs.
3. that you cannot rely on only one antibiotic.
4. that proper diagnosis is vital to choosing which antibiotic for which situation.

Now don't get me wrong--I recognize the validity of all these points, but having said that, I would like to rephrase this question in a different way:

If you were preparing for a situation in which medical expertise and supplies were unavailable, take a look at what the most likely risk scenarios are (what diseases or injuries one would be most vulnerable to), and in that light, what would be the number one antibiotic you would want to stock--the number two, and so on?

This wording, I think, puts the question in more relative terms--so that the less-knowledgable person, such as myself, would be able to decide where to put his or her money first--second--etc. I am old enough to remember the horror stories of the generation just preceding mine: people dying of bacterial pneumonia, which a course of antibiotics would have brought to an end--Uncle Max getting his foot cut in the thresher, having an amputation, and dying of "blood poisoning" in a short time. Granted, the individual would still need several drugs to cover the waterfront, and granted, he or she would need to learn what the hell to do with them--as well as a layman can do that sort of thing. But I would be interested in your thoughts, based on acceptance of all the usual (and correct) admonitions. Doctors, nurses, and medics, especially, but all comments would be welcome.

My thanks for the opportunity to join you.

Dinky

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duodecima
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Re: If you could have only one antibiotic...Redux:

Post by duodecima » Sun Jul 13, 2014 7:09 pm

Just thought I'd throw in a bunch of links to previous discussions on this forum regarding this topic - the OP has clearly read them thoroughly, but let's make it easy for those who haven't yet. Starting with the first thread of this title :

http://www.zombiehunters.org/forum/view ... s#p2104983
http://www.zombiehunters.org/forum/view ... 43&t=64718
http://www.zombiehunters.org/forum/view ... ntibiotics

and another relevant one
http://www.zombiehunters.org/forum/view ... 43&t=67482

There are a couple others I recall, but I think these cover the highlights of past discussions well.

As for the question, you've stipulated the conditions well. I'm going to have to think about that a bit. It does depend on the scenario a lot, because that changes what the risks are. Also - WHO are you taking care of in that situation - depending on age/underlying condition, I'd shift my favorites. Am I running a maternity service under primitive conditions? Taking care of my family on an overland bug out in my AO? Got dropped somewhere tropical somehow? Patching up refugees from armed conflict?

I think I'm going to formulate this question to myself as "How many/few oral antibiotics could you stock and still cover most of the waterfront?"

Great question!
"When someone shows you who they are believe them" M. Angelou

Dinky
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Re: If you could have only one antibiotic...Redux:

Post by Dinky » Mon Jul 14, 2014 1:13 am

Thanks, very much. To my discredit, I have not read all of those threads--yet--although I am very familiar with the first.

Of course you are correct: the answer would be very much scenario-dependent. My own thinking tends toward preparedness for the most likely vulnerabilities inherent in the most likely scenarios--weighted of course toward those maladies that, if encountered would
Be most likely to be fatal. I do not, for example, consider biological attack--say anthrax--to be as likely as a total political and economic breakdown of society, with a widespread and lasting situation involving the absence of production and distribution. In such a scenario, I would
envision a return to a Nineteenth Century agrarian lifestyle--accompanied by the added challenges of having to defend oneself from outlaw groups.

In my own case, I think of my forebears in West and South Texas, eking out a crop and raising steers in the midst of hostile Apaches and Comanches. I see the main SERIOUS exposures (in no
particular order) in such an existence as:

1. Respiratory: Pneumonia following influenza or any number of other ailments.
2. GI: Diseases from bad water (typhoid, cholera, Giardia and I suppose some
other non-bacterial beasties.
3. Skin and below: Prevention of bad infections from
Wounds
4. Dental: what would be rather routine suddenly becomes life-threatening.

Not sure what else--I know I have missed some. I can envision situations where the medical community would be available for services but would
lack the drugs to most effectively do your thing. Then you pop out your stash, let him
diagnose and prescribe, then pay with a cantaloupe or a
chicken! :)

Best regards

Dinky
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Re: If you could have only one antibiotic...Redux:

Post by Dinky » Mon Jul 14, 2014 1:18 am

I am deleting the text of this post, having received a friendly reminder that it might be considered political in nature. Sorry. Should have read the policy better.
Last edited by Dinky on Mon Jul 14, 2014 11:09 am, edited 2 times in total.

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Re: If you could have only one antibiotic...Redux:

Post by DannusMaximus » Mon Jul 14, 2014 11:03 am

Dinky wrote:...he or she would need to learn what the hell to do with them--as well as a layman can do that sort of thing. Dinky
I am NOT an expert on this by any means, but I think the learning what to do with them would be the easy part. You either take a dose orally or inject it, correct? Determining the dosage would be the difficult part and I presume there are tables available that give the appropriate dosage by body weight and route of delivery? Maybe that dosage is dependent on the infection severity or if it's being used pre-infection?

I know that when antibiotics are given at my ER, it appears the doctor either writes a standard dosage prescription to be picked up or they are injected in a metered dosage and concentration, generally through an IV line.

I might be wildly, WILDLY oversimplifying this. I'm perhaps invisioning a giant table that gives the antibiotic, what it's used for, contraindications, and dosages by body weight. And that might not exist. So, folks in the know, does it?
Holmes: "You have arms, I suppose?
Watson: "Yes, I thought it as well to take them."
Holmes: "Most certainly! Keep your revolver near you night and day, and never relax your precautions..."

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Re: If you could have only one antibiotic...Redux:

Post by woodsghost » Mon Jul 14, 2014 11:27 am

In one of my books on rural/wilderness medicine, dosages are given for the type of antibiotic and body weight. Dosage based on severity of infection/wound is not given. Injection is prefered for serious wounds/infections (meaning method of delivery changes, not dosage, IIRC). I don't stock antibiotics so I can't recite the exact dosages off hand.
Last edited by woodsghost on Mon Jul 14, 2014 5:09 pm, edited 1 time in total.
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Re: If you could have only one antibiotic...Redux:

Post by AS556 » Mon Jul 14, 2014 11:42 am

How does one even go about acquiring antibiotics in quantities sufficient for stockpiling?

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Re: If you could have only one antibiotic...Redux:

Post by woodsghost » Mon Jul 14, 2014 11:48 am

AS556 wrote:How does one even go about acquiring antibiotics in quantities sufficient for stockpiling?
Pet supply stores, but there are a huge number of issues with proper use and storage of antibiotics. Some antibiotics can become lethally toxic. Plus, there can be differences between pet and human antibiotics. Also, you don't just buy one type of antibiotic. Different types are used for different ailments. There can be different dosage requirements and different methods of administration. If that is something you are considering, please do a HUGE amount of research first and get some training.
*Remember: I'm just a guy on the internet :)
*Don't go to stupid places with stupid people & do stupid things.
*Be courteous. Look normal. Be in bed by 10'clock.

“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” -Bilbo Baggins.

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Re: If you could have only one antibiotic...Redux:

Post by duodecima » Mon Jul 14, 2014 12:00 pm

DannusMaximus wrote:I'm perhaps invisioning a giant table that gives the antibiotic, what it's used for, contraindications, and dosages by body weight. And that might not exist. So, folks in the know, does it?
Not precisely but sorta. There's an entire book called "The Sanford Guide" (pocket book but it keeps getting bigger :gonk: ). I will make a wild ass guess that if I turned an educated layman (i.e. one of you guys with an interest in such things but no formal training with meds) loose with it, the right choice would be made perhaps 50% of the time? The more training you add, the more likely the choice would be a correct choice if not THE correct choice. Actually, that might be another fun thread, almost like a postal match where given a scenario, people PM'd in their answers and maybe training level/experience, and we could post the answer key and stats on how many got it right. I could find out if I'm too optimistic or if I don't give the self-educated folks enough credit. No, I don't have time/energy to do that right now tho...)

If others have a "what one reference would you have if you could" book for antibiotics/infection, what is it?

Doses do vary for some but not all antibiotics, based on weight for kiddos, based on disease state (or suspected disease state) and severity for many conditions. (Also based on renal function, not practical to check under PAW conditions). Also based on dose frequency. (Eg Augmentin 500 3x/day vs 875 2x/day.) Also length of treatment course varies for the same reasons.

Really don't want to rehash everything we've said in the other threads, but diagnosis is key, and that's the thing that I don't think we can boil down into a finite number of pages.

Fake edit - AS556 - that's one of the more contentious things about this topic. Some folks stock fish and veterinary antibiotics (see relevant threads for discussion). Some folks don't use or finish stuff they were prescribed. :? Some folks lie to their doctors (found the thread on here with that one again last night. :evil: ). Occasionally someone will get a legit scrip from their doc for future use because of travel, wilderness circumstances, or predictable need in the future for a condition that patient knows very well. As we've covered at length in the other threads, antibiotics misuse and overuse is a huge issue that effects pretty much all of us.

Double fake edit - what woodsghost said!!! If I really thought the vast majority of folks weren't ever going to touch their stockpiles this side of a PAW (and were going to dispose of them at the community drug collection days when they were expired to rotate them) I'd be a lot less professionally wary of this issue.
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Re: If you could have only one antibiotic...Redux:

Post by woodsghost » Mon Jul 14, 2014 2:19 pm

For antibiotic information, I have a 2010 (or 2012?) copy of "Where there is no Doctor." One friend argues a more accurate title would be "Where the Doctor is 24 hrs away." Which is true. The book is focused on a limited level of care, and for cases needing more advanced care, it says to ship them off to the doc, who is always presumed to be 24 hours away.

An argument made constantly in the book is that our body is able to deal with a heck of a lot on it's own and medicines should only be used sparingly. Often, we use medicines almost like talismans and fetishes to ward off bad juju and don't trust our bodies to do what they are designed to do: keep us alive in rough conditions.

Antibiotics are only really necessary in deep penetrations of the body (severe lacerations, bullets), certain respiratory issues, and UTIs, if I understand the book correctly. Don't quote me on this folks :)

I am just presenting the argument I see in the book. I make no claim to expertise.

Given my level of training and experience, I am focusing on addressing issues without use of antibiotics. Which mostly means irrigation, disinfection, Ibuprofen (or other NSAIDS), and Acidimonophin (Tylenol). Oh, and change the dressings!!!!

[EDIT]
DannusMaximus wrote:I'm perhaps invisioning a giant table that gives the antibiotic, what it's used for, contraindications, and dosages by body weight. And that might not exist. So, folks in the know, does it?
The book I mentioned above does have a chart like this. Or rather, lots of pages. At least, the version I have does.

[Double Edit]

Also, as I understand the issue, certain germs in certain regions have developed resistances to certain antibiotics. Like in the South East of the US, some antibiotics will work on a disease, but in the Midwest, antibiotic resistant strains exist and you have to use something other than the normal antibiotic. England or Argentina (and other countries/regions) might need their own versions. Or drug resistance might not have arrived and you can use a more general antibiotic rather than a specialized one.
Last edited by woodsghost on Mon Jul 14, 2014 5:21 pm, edited 1 time in total.
*Remember: I'm just a guy on the internet :)
*Don't go to stupid places with stupid people & do stupid things.
*Be courteous. Look normal. Be in bed by 10'clock.

“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” -Bilbo Baggins.

Dinky
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Re: If you could have only one antibiotic...Redux:

Post by Dinky » Mon Jul 14, 2014 5:01 pm

Duo: I was thinking back to your very helpful list of your top 5 back in the first link you provided. As I recall, Zithromycin was the only one unavailable without prescription (via pet stores)--I think you can get them from overseas but...

Best regards

Editing to say that if I were a physician, (the first chapter of Organic Chemistry settled my hash), even without regard to Mister Hippocrates, the litigious nature of our society would render me highly reluctant to be overly liberal in prescribing medications.

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Re: If you could have only one antibiotic...Redux:

Post by CrossCut » Tue Jul 15, 2014 7:07 am

Dinky wrote:
If you were preparing for a situation in which medical expertise and supplies were unavailable, take a look at what the most likely risk scenarios are (what diseases or injuries one would be most vulnerable to), and in that light, what would be the number one antibiotic you would want to stock--the number two, and so on?
Dinky wrote: 1. Respiratory: Pneumonia following influenza or any number of other ailments.
2. GI: Diseases from bad water (typhoid, cholera, Giardia and I suppose some
other non-bacterial beasties.
3. Skin and below: Prevention of bad infections from
Wounds
4. Dental: what would be rather routine suddenly becomes life-threatening.
Not a doc but I'll take a shot, I love open book tests. If I could only have one antibiotic to treat as many of those infections as possible in the broadest range of patients, Amox/clav. Good coverage for #1, #3, and #4. Pen allergy might be an problem tho. #2 is tougher... I''ll guess: Doxy and Flagyl. Think those would cover most water-borne bacteria, plus some decent 2nd-line options for treating #3 and #4, or 1st-line for pen allergic patients.

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