Emergency antibiotics pro/cons ?

[Andy T]

A friend sent me a link to a video https://www.youtube.com/watch?v=vKfEE0i13wo that talks about https://jasemedical.com/pricing. What are the thoughts of having "just in case" antibiotics for emergency?

[ccmdfd]

I can see pros and cons to it.

My work self certainly has concerns, but I am also a patient and am reliant on a certain medication that I have to take every single day in order to live. After having read One Second After, within the past year or so, the thought of having an emergency situation where I no longer have access to that medication certainly has me thinking about stuff like that.

One thing to keep in mind is most antibiotics have a shelf life of about 12 months. Therefore you're going to need to replace this thing every single year. If you have four of them or five of them for the entire family that money certainly adds up quickly.

Also, if you've never taken some of these antibiotics there's always a chance that you're allergic to one of them and finding out in a true emergency is not a cool thing to do.

I guess in the end, I would not recommend something like this just to carry around with you and take every single time you feel like you have a cold or small fever. However if we truly are in a One Second After type environment, then the benefits of having this probably outweigh the risks.

[Andy T]

How long does shelf life last beyond a year? Any potential issues, besides lack of potency if taking expired antibiotics? I heard that expiration dates on medication are primarily a regulatory requirement.

One Second After trilogy was scary read.

[ccmdfd]

How long does shelf life last beyond a year? Any potential issues, besides lack of potency if taking expired antibiotics? I heard that expiration dates on medication are primarily a regulatory requirement.

One Second After trilogy was scary read.

Good questions which I would have to defer to someone with a PharmD degree.

[camel]

How long does shelf life last beyond a year? Any potential issues, besides lack of potency if taking expired antibiotics? I heard that expiration dates on medication are primarily a regulatory requirement.

One Second After trilogy was scary read.

I love/hate that trilogy for really distilling down a societal collapse.

I’ve been told that medications don’t really expire but they lose effectiveness. But would rather hear from more knowledgeable like has been said.

[SLN]

How long does shelf life last beyond a year? Any potential issues, besides lack of potency if taking expired antibiotics? I heard that expiration dates on medication are primarily a regulatory requirement.

One Second After trilogy was scary read.

Here is 2020 article from Harvard Health Publishing addressing the topic:

https://www.health.harvard.edu/staying-healthy/drug-expiration-dates-do-they-mean-anything

[whomever]

It might be worth asking your doc. We spend a lot of time in the backcountry, and our GP gave us a prescription (and advice) for a couple of antibiotics for our first aid kit. We were careful to explain the intended use wasn't to self-medicate in town, and only intended to use them while waiting for a rescue (or self-rescuing).

He picked two and said '#1 is for diseases A, B, C, ...; #2 is for diseases M, N, O, ..., and if you aren't sure they don't have any negative interactions so take both'.

Since insurance doesn't cover a prescription like that, he picked two that were on Target's $5 list.

His directions and the pills are in our first aid kit.

Not all docs will be agreeable, but it might be worth asking at your next physical.

[Rick R]

How long does shelf life last beyond a year? Any potential issues, besides lack of potency if taking expired antibiotics? I heard that expiration dates on medication are primarily a regulatory requirement.

One Second After trilogy was scary read.

I took doxycycline daily for a few years due to a skin issue and the prescribing doctor (who I greatly trust) warned that it could become toxic at some point after the expiration date.

One Second After is a thought provoking series though there are still people living a lifestyle here in WV who wouldn’t really notice for a couple years.

[MickAK]

I would add antibiotic eye drops to that kit. Having a family member lose vision over an easily treatable infection would suck.

More important than having the materials is having the knowledge and training to use it or be able to seek the advice of those that have it. Infections can be difficult in that regard. Being able to send pictures with your emergency communications is really helpful for telemedicine.

[Sensei]

If we’re talking about random, oral, prophylactic antibiotics where the prevalence of disease is low, then they are more likely to harm you. A good example would be packing a dose of cipro and keflex in case you get shot in downtown Newark.

On the other hand, targeted oral, prophylactic antibiotics where the prevalence of disease is higher may have a role. This is illustrated by soldiers being given cipro and keflex in their aid bags in case they are blown up by an IED in the desert where the sand is carrying all kinds of nasty shit and definitive care could be hours away.

[LOKNLOD]

It might be worth asking your doc. We spend a lot of time in the backcountry, and our GP gave us a prescription (and advice) for a couple of antibiotics for our first aid kit. We were careful to explain the intended use wasn't to self-medicate in town, and only intended to use them while waiting for a rescue (or self-rescuing).

He picked two and said '#1 is for diseases A, B, C, ...; #2 is for diseases M, N, O, ..., and if you aren't sure they don't have any negative interactions so take both'.

Since insurance doesn't cover a prescription like that, he picked two that were on Target's $5 list.

His directions and the pills are in our first aid kit.

Not all docs will be agreeable, but it might be worth asking at your next physical.


We did similar when we were planning our trips to Africa. Explained that we expected to be pretty remote from what we’d consider normal standard of care and wanted to make sure we had bases covered. Our doc at the time put together a good little kit with some good versatile meds including antibiotics.

I’m allergic to penicillin/amoxicillin so having alternatives to those very common ones is important to me, too.

[JCN]

How long does shelf life last beyond a year? Any potential issues, besides lack of potency if taking expired antibiotics? I heard that expiration dates on medication are primarily a regulatory requirement.

One Second After trilogy was scary read.

It’s very medication dependent.

This was methotrexate (not an antibiotic) out of Yemen.

https://www.google.com/amp/s/www.pbs.org/newshour/amp/world/expired-drug-kills-10-child-leukemia-patients-in-yemen

[45dotACP]

I'm at least somewhat involved in the field of healthcare and I'd be deeply hesitant.

Shelf stability is one thing, but loading up on the wrong abx can have you shitting your pants with a C. Difficile infection, you could develop a resistant bacteria, depending on how healthy you are you might blow up your kidneys or pop a tendon...not a great call.

Antibiotic ointments or eyedrops are different. I've used plenty of antibiotic ointments to treat a staph infection and keep it from getting real bad.


That said I'd keep IV fluids and supplies on hand...for when you have nights you've partied too hard.

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[ST911]

What are the thoughts of having "just in case" antibiotics for emergency?

It's all about knowing what to use and when. Having a regular bout of whatever that you're treated the same for each time is different than stockpiling stuff and self-diagnosing. Most common things are pretty simple, until they're not.

Expiration dates on meds aren't the thing we're told. Dates on a med may be years longer when it's packaged to sit on a disaster pallet or is shipped to an overseas market than when it goes to your local CVS. No doc or pharm is going to bless an exp+2 or exp+5 year med, but most are likely fine if stored smart.

[DocGKR]

I served a couple of decades in the military--we frequently were told to extend drug shelf lives on many medications and had no difficulties. Obviously you have to be smart and know what can become a problem....

[YVK]

I would suggest to review literature on appropriateness rates of antibiotic administration in medical settings by medical professionals before deciding whether a non-medical person can make a right call on that.
I would only preemptively stock for a specific pathogen(s) expected in a specific location / situation.

[Paul D]

1) When I go to Africa, besides taking malaria prophylaxis meds I took supplies of antibiotics targeting possibilities for GI infections and skin wounds. I don't this while I'm at home. I would discuss this idea with your physician. It's like those guys with a shit load of medical supplies in their FAK which they have no business using without training or expertise.

2) I tell my patients to place medications in a ziplock bag in the fridge or freezer. They will last nearly forever. My buddy did an experiment in fellowship where he placed commonly used mailordered packaged meds in a mailbox in the Phoenix heat for a weekend. He would compare them chemically to reference meds. He wondered if leaving medications in a hot Phoenix mailbox was a bad thing. There were not any real differences. However, the packaging of mailorder drugs back then made Costco theft proof packaging look weak.

[Shawn Dodson]

I keep some Z-Paks (https://www.drugwatch.com/zithromax-z-pak/) handy.

I asked my doc if I could get a script for Z-Paks during a routine check-up, but he said he couldn't write a script because he just documented that I was in good health, however if I called in a few weeks later and asked for a script because I think I have bronchitis then he'd approve it. Over the years, I've been able to maintain Z-Paks that aren't "expired".

[TCinVA]

How long does shelf life last beyond a year? Any potential issues, besides lack of potency if taking expired antibiotics? I heard that expiration dates on medication are primarily a regulatory requirement.

One Second After trilogy was scary read.

The DOD did a study sometime back looking at the shelf life of medications and found that if they were stored reasonably, pills were still over 90% as potent even 15 years after expiration (https://www.health.harvard.edu/staying-healthy/drug-expiration-dates-do-they-mean-anything). Obviously this doesn't mean leaving them on the dashboard in your car year round. Kept away from light and in relatively stable temperatures and away from moisture they'll store and stay potent for a very long time.

Liquid solutions of medications and certain types that require refrigeration, etc are obviously not going to play by those rules. But your typical pill is just fine.

It is fairly common for folks looking to prep for bad conditions to get hold of various types of antibiotics in case of disruption or social upheaval that can disrupt supplies. Their efforts are usually centered on getting hold of a few broad spectrum antibiotics that are effective against a number of different types of infections. It's something you want to have a good medical reference to help guide for purchasing. There are a few readily available guides to help give you an idea of what antibiotics are commonly used for what infections. (Stanford Guide to Antimicrobial Therapy, etc)

Antibiotics have downsides in that they roll through like an invading army and kill lots of good organisms too, so they are not to be trifled with willy nilly. But if you can't get to a doctor because the medical system has collapsed having the right blend of broad spectrums can save a life. So treat it like that.

If you take prescription medications regularly, having a sizable supply in case of the same disruptions can be useful. Often if you tell docs you will be traveling to interesting places they will give you an extended supply and maybe even some antibiotics for stomach bugs and the like. Or you can buy almost anything you want from several grey-market pharmacies with good reputations.