Dear Doug, I have a suggested change in the antibiotic that you carry in your pocket survival kit. My suggestion is to change the use of Zithromax to an antibiotic called Levaquin. Levaquin is a very potent once a day antibiotic that falls under the same class of antibiotic as Ciprofloxin. We have been using it to cover both pneumonia, complicated upper respiratory infections, urinary tract infections, and complicated skin infections. This in my opinion covers the majority of infections that might be encountered in a survival situation. This is a much broader coverage of infections than Zithromax was designed to cover. Unfortunately, in addition to this, recent articles from the infectious disease folks state that types of bacteria increasing their resistance to the drug is growing, so what this means is the drug may fail and cause a worse infection. It should not be to hard to fit the Levaquin in your kit. The Tablet is slightly bigger and you need 7 vs 5 tablets, but i had no problem putting it in my kit. The course of the drug is usually 7-10 days, but the extra 3 tablets is usually meant for people who stop taking their antibiotics after day 5 when they feel better so the extra pills makes them think that they still have a ways to go. SO FINISH ALL YOUR ANTIBIOTICS WHEN ARE TOLD TO BY A MEDICAL PROFESSIONAL. So in conclusion talk to you physician or mid level practitioner and tell them what this is for, most are outdoor folk like ourselves and understand what you are trying to achieve. Ask them to write you a prescription for Levaquin 500mg for seven days. Oh, and by the way the tablet is flat on the sides so if you vacuum seal it they fit right up to each other. And one final note most people can take this medication without any problem, UNLESS YOUR ARE ALLERGIC TO ANY MEDICATION IN THE QUINOLONE FAMILY, YOUR HEALTH CARE PROVIDER WILL BE ABLE TO TELL YOU.<br><br>P.S. If there are medical oriented questions out there I would very much like to help you get the correct information.<br><br>

I take it levaquin is also a floroquinolone. If so, I'll stick with zithromax. Me and Cipro had a nasty meeting a few years ago, so watch for allergies.<br><br>

Zithromax is an inferior antibiotic for use in a survival setting. I would suggest Tequin which is a once a day quinolone (antibiotic class) that is effective against urinary tract, upper respiratory infections. It does have an FDA approved indication for treatment of soft tissue infections. I have never used it for that purpose. <br>If your concern is skin and soft tissue (wound) infections, then an anti-staph drug like Keflex or Duricef would be superior. <br>There is no primary indication for using Zithromax except in the treatment of community acquired pneumonia.<br>I have added both drugs to my military survival vest as well as the kit I fly with in general aviation aircraft.<br><br>Jeffery S. Anderson, M.D.<br><br>

>>>If your concern is skin and soft tissue (wound) infections, ...<<<<br><br>What should be one's concern? And under what conditions?<br><br>Specifically, most, but not all, of the information on this site is geared towards pilots. I am a casual outdoorsman on weekend outings with the Boy Scouts. We rarely go anywhere that's not within hours of help, perhaps a few days under extreem circumstances.<br><br>And of course, I travel in my car, which could leave me stranded overnight, or a few days under extreem circumstances.<br><br>Under these two scenarios, are the medication requirements different than what's described on the site and in this forum?<br><br>A second question I have is with regards to pain medication. One of the kits I am assembling is for my son, who is a minor. Of course I'd consult with his physician before outting anything besides his dailt asthma meds in the kit. But I slightly worried about a minor carying perscription pain medication in his fanny pack or backpack.<br><br>I know my son is mature enough to understand the issues and seriousness of having such medication. Plus he's been very responsible in handling his medications for asthma over the years. But I'm still unsure if it's wise to include them in his kit. Any thoughts?<br><br>Willie Vannerson<br>McHenry, IL

This is all WAY OVER MY HEAD :)<br><br>

If you are a "casual outdoorsman" on weekend camping and hiking trips your needs will be much simpler than if you are going to a remote area without a "911" response.<br><br>If you are a weekender, it is unlikely that you will be able to get too far from help. I would think that it is reasonable to be able to cover minor wounds for staph and strep. Keflex (cephalexin) is a good choice in a generic medication. It is a penicillin cousin and allergy may be an issue.<br><br>If you are going further away, such as to the Boundary Waters Canoe Area or trekking out of the country, then additional problems can be troublesome. I would want a broad spectrum drug that would cover urinary tract, respiratory tract, and travelers diarrhea. A good choice for "below the belt" is Cipro (ciproflaxin). A better choice may be Tequin, one of the newer quinolone antibiotics. The added advantage of Tequin is that there is no risk of photosensitivity reactions as there is in Cipro.<br><br>Regarding pain medications, it is unlikely that there is sufficient risk of injury to warrant the cost and need for security of an injected narcotic for weekend trips. I would take them, because I have them in the office. For a layman, the issue is more complicated. Not impossible, but more complicated. <br><br>For remote trips, an injected narcotic is a needed addition. I would avoid being sidetracked with claims that Toradol is as effective in pain relief as a narcotic. It ain't so.<br><br>There is an excellent reference on remote medical kits in "Management of Wilderness and Environmental Emergencies" by Paul Aurebach.<br><br>Good luck!<br><br>Jeffery S. Anderson, M.D.<br><br>

Physician's Desk Reference is pretty vague on the actual uses of theses drugs. One that I have always used is Erythromicin. I admit it is quite bulky, but it is cheap.<br><br>I am not quite sure how well the drug works, whether or not I could have used aplacebo or not, but I have used and used it on others for skin infections and have found it to be quite effective.<br><br>At the moment I carry Cipro in all of my First-Aid-Kits.<br><br>What is your opinion of stockpiling anti-biotics and using them for infection.