Izzy, I'm clarifying a few things in the kindest spirit of knowledge sharing...It's just important that accurate info is presented here on this board. I'm sure you'd agree with that.
That being said antibiotics really only last effectively for 3 months according to the Physicians Desk Reference.
The oral antibiotics in my pharmacy: A) Are not produced in amber vials, but usually white opaque bottles. We dispense them in amber vials because *some* medications are light sensitive, and it's easier if they are all amber for those cases B)Will have expiration dates ranging from 2-3 YEARS. We will send back any that have an expiration date less than 1 year.
The PDR is a compendium of product information published by the pharmaceutical companies. Although somewhat useful, it doesn't always tell the whole story; only what the FDA has ruled that company is allowed to tell. Much better references are Facts and Comparisons or Micromedex. Heck, even Epocrates is decent for some basic knowledge. BTW, PDRs are often given away free...that might tell you something. Epocrates is free too, but it's actually quite good for a brief summary of Rx information.
As for how they should be destroyed or thrown out...is being debated. You might recall recently the E.P.A. did a test of major public water systems and found of all things strong trace levels of antibiotics.
Strong trace...? Unless one believes in homeopathy...then the less there is of a substance, the more powerful it is. Back in the real world... The term "trace" indicates minuscule amounts. The amounts in that latest EPA scare were exactly that, trace. The main thing the EPA was concerned about was the fish being altered by the presence of some of the compounds. Fish (and amphibians!) are far more sensitive to things in the water than us mammals. The EPA went out of their way to emphasize that this does not represent a danger to humans. Funny how that didn't make it to the headline...
Current recommendations are still to flush them down the toilet.
Good job on the "finish your antibiotic" discussion! Ditto! The worst way to build up an emergency supply of antibiotics would be to not finish the prescription and keep that as your supply.
Personally...I think a Doctor's office should have a box much like "Sharps" box that holds used syringes. This box could be filled by unused antibiotics that patients or the doctor do not fully use and thus are properly disposed of. Possibly burned like most medical waste is.
Your instincts are well-founded. This service is available in select locations as a kiosk. People dump their used meds in and they take it to get incinerated. (Makes you wonder how many drug addicts will be kiosk-diving thinking their junk is in there!) I think it's pretty sparse, however; most clinics will just tell you to flush it if you call for this service.
Also....your Doctor isn't allowed to just give you medication, even for a kit. That's a violation of the DEA Agreement. He may, but it's not a very ethical thing to do. Doctor's are not even allowed to call in medication for themselves or relatives. A recent issue of National Geographic Adventurer is being really haranged by the medical community for telling people to "get a lot of antibiotics from your doctor before ever traveling."
They can't prescribe controlled substances (Lortab, Morphine) for themselves. That's the only thing the DEA regulates. They can prescribe antibiotics for themselves or family members. (Prescribing for himself is usually frowned upon, though not illegal) Absolutely nothing unethical about prescribing antibiotics for travel outside the country. It is quite routine to prescribe antibiotics to deal with the possibility of traveler's diarrhea. One issue a prescriber might debate is whether the person can "self-diagnose" a bacterial infection. There are women who know they have a yeast infection (believe me, they know!) and most docs I work with will just call it in for established patients without seeing them (if it's the 2nd time for the yeast infection) But it's a case by case basis; every prescriber has his/her comfort zone for such things.
I will join the haranguing against that National Geographic Adventurer for encouraging people to "get a lot of antibiotics before ever traveling." The prescriber should only prescribe those antibiotics and/or immunize according to well-established guidelines (See Sanford's guide). It would be foolish for people to try to get "lots of" antibiotics to "self-diagnose" a condition in another country.
My final take on storing antibiotics for BOB use is that it is probably unnecessary for most situations that are not catastrophic and long-lived. However, if you travel to 3rd world countries, it would be a good idea. Get your shots, too!