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Thread: A Doctor's Thoughts on Antibiotics, Expiration Dates

  1. #1
    Angel4JohnnyB Guest

    Default A Doctor's Thoughts on Antibiotics, Expiration Dates

    Borrowed this from SurvivalBlog! Who'd a thunk it!!!!! Fish antibiotics!! WOW!!!!

    http://www.survivalblog.com/2010/07/..._antibiot.html

    A Doctor's Thoughts on Antibiotics, Expiration Dates, and TEOTWAWKI, by Dr. Bones


    As a recently-retired physician who is married to a nurse-midwife, my preparedness group looks to us as the post-TEOTWAWKI hospital and medical staff. Medical progress has been exponential and even just the last decade of scientific breakthroughs can equal a century of improvement in medical treatments, surgical techniques and pharmaceuticals. However, in the years (months?) ahead, the crumbling of the infrastructure and devolution of society in general will very likely throw us back to a medical system that existed in the 19th Century.

    Let’s take an example: When the U.S. was a young nation, the average woman could expect to be pregnant 10-12 times during her reproductive lifetime (no reliable means of birth control). One out of four women would not survive the pregnancy, either from issues relating to blood loss from miscarriage or childbirth or Infection (no antibiotics) following same. A myriad of other complications occurred which are treatable today but weren’t back then. I collect old medical books, and even relatively modern obstetric textbooks devoted entire chapters on how to crush a fetus’ skull in order to expedite its removal from a critically ill mother, with instruments that clearly had no other purpose. When childbirth was successful, she could expect perhaps 3-4 of her children to survive to become adults, on average, with many minor children succumbing to simple infections that had no known effective treatment at the time.

    This is the grim reality that we, in modern times, will face when the inevitable happens and current medical technology and treatments are unavailable to us.

    There is an interesting post-TEOTWAWKI series by History Channel called “After Armageddon” which can be viewed on YouTube. Interestingly enough, it doesn’t appear on History Channel’s list of shows). In it, a family seeks refuge in the aftermath of an apocalyptic event. The father of the family, who is a trained EMT, falls sick and dies from a simply cut on his hand because the antibiotics ran out. It shows that the lack of accumulated stores of antibiotics could mean a shortened life span for even the most prepared individual.

    Given the new situation that we will have thrust upon us, it behooves every aware individual to begin to stockpile medications that will be needed in the future, and to become trained one way or another in basic and disaster first aid. Even if your group has a designated “medic”, you have an obligation to be able to handle medical issues in a catastrophic scenario for the sake of your group and your family. Just as the designated “medic” should be trained to handle security issues and should accumulate food and other supplies, so should you accumulate medications and medical supplies. Cross-training is essential for when the medic needs a medic!
    Accumulating medications may be simple when it comes to procuring aspirin and other non-prescription drugs but may be problematic for those who cannot write their own prescriptions or don’t have a relationship with a physician who can. I would like to focus on the issue of procurement of antibiotics for the treatment of infection in this essay, as there are already a number of good essays on this site that discusses various aspects of medical care in the post-SHTF era. I heartily recommend that everyone read these in detail.

    For all intents and purposes, it is highly unlikely that even basic antibiotics like Penicillin will be actively manufactured in an apocalyptic scenario due to the complexities in said manufacture. Those who say, “it’s just bread mold” are naïve if they think just making prepper bread and letting it sit will produce anything That would cure an infection (penicillin is actually made from liquid that the mold produces under certain man-made conditions. And, no, Ginger Root and other “home antibiotics” probably won’t either.

    The reason that I consider this a major issue is that there will be a much larger incidence of infection when people start to fend for themselves, and injure themselves as a result. Simple cuts and scratches from chopping wood can begin to show infection, in the form of redness, heat and swelling, within a relatively short time. Treatment of infections at an early stage improves the chance that they will heal quickly and completely. However, many preppers, being the rugged folk that they are, are most likely to ignore the problem until it gets much worse and spreads to their entire body, causing fever and other systemic problems that could eventually be fatal. Have antibiotics already on hand in their retreat would allow them to deal with the issue until medical help (if available at all) arrives.

    Now, what I am about to tell you is contrary to standard medical practice, and is a strategy that is best used in the event of societal collapse that causes the unavailability of conventional medical care for extended periods of time. This line of thought that I am presenting is that “sumpthin” is better than “nuttin” and is not meant to serve as official medical advice for any circumstance but a catastrophic breakdown of our infrastructure and ability of our country to provide medical care for its citizens. If there is modern medical care available to you, seek it out.

    Small amounts of medications such as antibiotics could be procured by anyone who is willing to tell their physician that they are going out of the country and would like to avoid “Montezuma’s Revenge”. Ask them for Tamiflu for viral illness and Z-packs, Amoxicillin or Keflex for bacterial diarrhea. Stockpiling of these antibiotics is more of a problem. After searching far and wide, I have come across the best option for the prepper: Aquarium Fish antibiotics.

    For evaluation purposes (and because I am an aquarium hobbyist), I decided to purchase online a variety of these products and found them to be identical (unlike some Dog and Cat medications) to those used to treat humans with a doctor’s prescription. I was able to purchase them without any demand for medical licensure, etc. The drugs are listed below and the bottles list the antibiotic as the sole ingredient. They are:

    * FISH-MOX (amoxicillin 250mg)
    * FISH_MOX FORTE (amoxicillin 500mg)
    * FISH-CILLIN (ampicillin 250mg)
    * FISH-FLEX Keflex 250mg)
    * FISH-FLEX FORTE (Keflex 500mg)
    * FISH-ZOLE (metronidazole 250mg)
    * FISH-PEN (penicillin 250mg)
    * FISH-PEN FORTE (penicillin 500mg)
    * FISH-CYCLINE (tetracycline 250mg)

    These medications are available usually in plastic bottles of 100 tablets for much less than the same prescription medication at the pharmacy (some come in bottles of 30 tablets). The dosages are similar to that used in humans, and are taken two to four times a day, depending on the drug. The 500mg dosage is probably more effective in larger individuals. Of course, anyone could be allergic to one or another of these antibiotics, but not all of them. (Note that there is a 10% cross-reactivity between "-cillin" drugs and Keflex, meaning that, if you are allergic to Penicillin, you could also be allergic to Keflex). FISH-ZOLE is an antibiotic that also kills some protozoa that cause dysentery.

    NOTE: It should be emphasized that FISH-CYCLINE [and other tetracycline antibiotics of various names] can become toxic after its expiration date, unlike most of the other medications listed. So consider acquiring the other ones listed, first.

    Which brings me to a question that I am asked quite often and to which my answer is, again, contrary to standard medical recommendations but appropriate in a post-TEOTWAWKI environment where no medical care is otherwise available. The question is: What happens when the medications I stockpiled pass their expiration date?

    Since 1979, pharmaceutical companies have been required to place expiration dates on all medications. Officially, this is the last day that the company will certify that their drug is at full potency. Some people take this to mean that the medicine in question is useless or in some way harmful after that date. With few exceptions (tetracycline being one previously mentioned), this is what I delicately term as “a bunch of hooey”!

    Studies performed by the Food and Drug Administration (FDA) revealed that 90% of medications tested were perfectly fine to use 8-to-15 years after the expiration date. There was apparently no danger in the grand majority of cases. The FDA tested more than 100 medications, both prescription and non-prescription, and continues to study the issue today. The exceptions were mostly in liquid form (antibiotics included, but also insulin, nitroglycerine and some others). What is true is that the potency of an antibiotic could possibly decrease over time, so it is important that your medication cache is in a cool, dry place if at all possible. Refrigeration is an excellent method to maintain the full potency of many drugs.

    Many people gauge their preparedness on the number of full ammo boxes in their closet. I’ve got them too. However, preparedness doesn’t mean going out in a blaze of glory; it means going on, in the best health and condition, to re-establish a peaceful and productive society. Every prepper should have antibiotics as part of their medical supplies. They’re available, they’re cheap and they could save your life.

  2. #2
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    This Dr. confirms everything I have believed for quite some time based on my own research. He mentions tetracycline degrades over time... I will not question whether this is true for the fish meds, but I do know that the human formulation (which this USED to be true about) was re-formulated many years ago to avoid that issue, and is now considered to be as shelf-stable as any other antibiotic.

    IMHO he mentions the fish antibiotics and not the human-grade foreign antibiotics due to legalities. The former are unquestionably legal, the latter are a grey area... technically, there are laws prohibiting their importation for human use. However, I have never heard of a prosecution for any non-controlled substance such as antibiotics. The worst that is likely to happen is that the shipment could be intercepted and confiscated. This happened to me once and the pharmacy immediately shipped a replacement product at no charge.
    In a crazy world, it's the crazy man who can get by - and it's about to get cray-cray up in here.

  3. #3
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    Doc you may want to expound upon how antibiotics were preserved and passed between individuals when they were first created.

  4. #4
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    has anyone tried buying any of these yet?


    What are prices like? What is avalability like?

  5. #5

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    We have used the Fish-Mox on animals alot with no problems. I've taken it twice and my wife several times, always worked and I didn't come up with scales on my skin.

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    I will have to be very careful on this thing because my daughter can not even touch the cillian's at all. So i must keep the cycline on hand, friged up of course.

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    Quote Originally Posted by X-cop View Post
    has anyone tried buying any of these yet?


    What are prices like? What is avalability like?
    Here is a thread on this subject from a few months back - LINK

    From that thread, there was a couple of sites suggested - http://vetamerica.com/fish-supplies-antibiotics.aspx and http://www.aqua-mox.com/Order.php

    Ordering some anti's is on my short list of things to do. Gotta get on it. Nice to hear the mention of the change in the tetracycline formulation. I'll shoot an email to a pharmacist friend and see if she knows the skinny on that.
    ΜΟΛΩΝ ΛΑΒΕ

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    This is definitely something Survivalists should read.

    It brings the 'Rambo-GI Joe live out in the mountains and machine gun the zombies' line of thinking to a complete hault. Also, during a disaster it shows that painkillers and bandages are going to be hot sellers. Survivalist Joe Bloggs will share his MRE's with you if you can fend off an infection his five year old daughter came down with. And for yourselves, Prevention is king. Stock up on any medicines you will need before things get bad.

  9. #9
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    Your pharmacist friend may not be aware of the change. Pharmacists are trained to adhere to the listed expiration dates and to instruct patients to do the same. This protects the pharmacy, the pharmacist and the pharmaceutical manufacturer from liability. There really is no professional motivation for a pharmacist to explore outside those boundaries, so unless they have had some reason to research this independently, they may simply be unaware of the information.

    Here are some sources of information for you to digest. Feel free to have your pharmacist friend review this information and discuss it with you. My inclination, if they bother to look at this at all, will be to simply dismiss it because they are indoctrinated by the "party line" that the drug manufacturers dole out.

    Drug Expiration Dates: How They Benefit the Pharmaceutical Companies
    SHELF LIFE EXTENSION PROGRAM
    Many Medicines Are Potent Years Past Expiration Dates

    On tetracycline specifically:
    Some 'expired' medicine OK, tests say
    The Medical Letter could find just one reported case in which a patient may have been harmed by taking an expired drug. It occurred more than 40 years ago and involved a patient who may have suffered kidney damage from taking expired tetracycline, an antibiotic. Since then, tetracycline products have been changed to eliminate the problem.
    Much "information" about tetracycline is being parroted blindly by those relying on the older data (and formula) from the 1960's in order to "err on the safe side" or simply due to unwillingness to research further.

    ETA: From one of the above sources:
    Consider aspirin. Bayer AG puts two-year or three-year dates on aspirin and says that it should be discarded after that. Chris Allen, a vice president at the Bayer unit that makes aspirin, says the dating is "pretty conservative"; when Bayer has tested four-year-old aspirin, it remained 100% effective, he says.

    So why doesn't Bayer set a four-year expiration date? Because the company often changes packaging, and it undertakes "continuous improvement programs," Mr. Allen says. Each change triggers a need for more expiration-date testing, he says, and testing each time for a four-year life would be impractical.

    Bayer has never tested aspirin beyond four years, Mr. Allen says. But Jens Carstensen has. Dr. Carstensen, professor emeritus at the University of Wisconsin's pharmacy school, who wrote what is considered the main text on drug stability, says, "I did a study of different aspirins, and after five years, Bayer was still excellent. Aspirin, if made correctly, is very stable."

    Only one report known to the medical community linked an old drug to human toxicity. A 1963 Journal of the American Medical Association article said degraded tetracycline caused kidney damage. Even this study, though, has been challenged by other scientists. Mr. Flaherty says the Shelf Life program encountered no toxicity with tetracycline and typically found batches effective for more than two years beyond their expiration dates.
    Last edited by bruss01; 07-27-2010 at 11:30 AM.
    In a crazy world, it's the crazy man who can get by - and it's about to get cray-cray up in here.

  10. #10
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    I did some further looking and it appears that the change that was made to the tetracycline formulation was the removal of citric acid, which may have caused the medicine to degrade over time. New HUMAN formulations do not contain citric acid. I cannot advise on whether the fish or vet grades contain any. I found biochemical (highly technical and outside the reference of the average patient) papers that discussed tetracycline's propensity to degrade in the presence of acidic media.
    Last edited by bruss01; 07-27-2010 at 12:14 PM.
    In a crazy world, it's the crazy man who can get by - and it's about to get cray-cray up in here.

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