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Thread: When/how to change antibiotics

  1. #1
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    Default When/how to change antibiotics

    I'll preface this by saying I'm essentially clueless when it comes to medicine. Even worse, I'm probably more dangerous than most idiots because sometimes I think I might actually understand something that I really don't. Anyway, treating bacterial infections after the SHTF - how long do you give your first line ABX choice time to work before you can say it's having a positive therapeutic effect, or that it's not and it might be time to switch to a different one? And if you conclude it is time to switch to a different ABX, what's the best way to do that?

    As an example scenario, say your friend shows up a week late, on foot, to your BOL after a SHTF event. He had some trouble along the way, and has a laceration across the knuckles of one hand from striking the teeth of the troublemaker a couple days ago. It's not bleeding, but it's red/warm and swollen enough that it's difficult for him to clench his fist. Maybe a low grade fever, if that'd make sense here too. He forgot his FAK when he had to abandon his vehicle, so he just wrapped his hand with a bandana. Just to make things more micro-biologically interesting, say that since the fight he's been rummaging through garbage cans/dumpsters and washed his hand in a couple ponds/creeks he found during his trip.

    Actual wound care aside, not interested in discussing wound closure, I&D, or disinfecting/dressing it, but how and when a med professional would switch to a different antibiotic if their first choice didn't seem to be working. Let's say I chose Amox/clav 875mg bid for my friend, and 3-4 days later the swelling hasn't gone down much if at all, maybe his fever is a little higher, and I think I might see a red streak forming on the back of his hand heading toward his wrist. Is 3-4 days long enough to conclude it's not active against the infection? Stop the Amox/clav and switch to clindamycin maybe? Continue the Amox/clav, and add clindamcyin too? I'm assuming we only have the available oral fish-ABXs, no injectables.

    Substitute a better example if necessary, just interested how a med pro might handle something like this when consulting a specialist or sending a culture to the lab isn't an option. Any general rules we might apply?
    Everything marked, everything 'membered. You wait, you'll see.

  2. #2
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    I had a professor in school one time that probably said it better than anyone else could have. In our own little world, we spent a considerable amount of time trying to avoid being sick or trying to outsmart the common cold. When we do get sick, we want a instant cure.

    Catch a cold, take some medicine.

    Cut our finger, take some medicine.

    Have a headache, take some medicine.

    Some things are better left alone, let it take it's course, do not worry so much about the little things until they become big things.

    If each time we have a problem we take an antibiotic, we develop immunities to those antibiotics. Each time we have a problem, it takes a more powerful antibiotic to get rid of the problem. Eventually the pathogens becomes more and more immune to the antibiotics until it gets to the point of where nothing we have works anymore.

    The biggest problems with this mentality is that we do not understand what we are messing with because this type of technology is relatively new to us - less than 70 years old in most cases. The more medicines we take, the more medicines we evacuate and the more medicines introduced into our lakes and streams and water systems, the more people are getting sick from this pollution and so each generation becomes a little more sensitive to these changes.

    All of the allergies our children has today, all of the mental and physical problems they have can be directly related to the medicines we have taken both knowingly and unknowingly in our lifetime.

    I honestly have to wonder how concerned a doctor gets when one of their children is sick. Do they rush right out and try to cure it with modern medicine, or do they take the wait and see approach...

    The doctors themselves never really ever seems to get sick, yet they are exposed to this in large doses on a daily basis. Is there some type of immunity? Does the doctor bring these pathogens home with them? Does contact with the sickness cause immunity?

    I myself would have a hard time admitting others to my Bug Out Location.
    Mostly due to the fact that it would need to be kept a secret as long as possible in order for it to work for me. When I get there, I might discover that I have neighbors that I never intended on having and I might have disputes that might need to be taken care of = where I wouldn't want others around to try to talk me out of doing what I might need to do to secure my place in that ecosystem...

    There are very few places in this world where it is so remote that people will not come looking for a place to stay in the same place as where you are going, just due to the nature of people and the fact that if they see smoke they will associate smoke with fire and fire with food and food with people.

    Depending upon the nature of the situation, if another country was to invade and our country was to succumb to the enemy, I wouldn't want to live by their rules or under their dictatorship. Eventually whatever happens, even the invading nation would screw up and another force larger, stronger or smarter would overtake them and then it would start all over again..

  3. #3
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    This ^^^^^^
    Sometimes we need to get sick to strengthen our immune systems. There is a lot of info on here regarding ABX, just do a search. Also on another site I frequent,
    they have regular posts by a Dr. who seems fairly intelligent. (Survivalblog.com) You can search the topic and print out the info. it will tell you about exp. dates and what to use for each ailment. some very good info. The guys here are great for info (Fidel) and I have learned a lot over the years.
    p.s. You should stock up on the ABX's for your fish, nothing worse than a sick fish during a SHTF scenario.
    Armageddon Catering....Providing All Of Your Post SHTF And TEOTWAWKI Needs.

  4. #4
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    Quote Originally Posted by Deerhunter View Post
    Some things are better left alone, let it take it's course, do not worry so much about the little things until they become big things.
    DH, in the scenario laid out, this is terrible advice. I get your overall point and agree, but not in answering the question presented.

    Marked, I'm not a Dr., and I don't play one on tv. I'd go oldschool, use as high a heat compress as the patient can stand for 15 or 20 minutes a couple times a day in conjuction with the antibiotics currently in use. The idea is to "cook" the bacteria into oblivion. I see this as a supplimental aid to the bodies own "fever" reaction but localized by the compress.

    Hopefully Fidel will chime in.
    777 FGG

  5. #5
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    Quote Originally Posted by hadite81 View Post
    This ^^^^^^
    Also on another site I frequent, they have regular posts by a Dr. who seems fairly intelligent. (Survivalblog.com)
    Doc Cindy of http://armageddonmedicine.net? Actually, it was her antibiotic guide (http://armageddonmedicine.net/wp-con...-and-Dose1.pdf) that re-raised this question in my mind on what to do if you suspect you're dealing with a bacteria resistant to the first line choice (edit to add: or I misdiagnosed it - if I had a medical specialty, it'd be misdiagnosis). I posted this same question to her on that article, said it was awaiting moderation, that was about 2 weeks ago...

    Trip: Thanks for the compress idea, and yea, was hoping the good Dr might chime in.

    (edit again, ok, rude comment removed)
    Last edited by marked; 06-17-2014 at 02:03 PM.
    Everything marked, everything 'membered. You wait, you'll see.

  6. #6
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    I think the red streak is an indication of blood poisoning. Bad juju. Very bad.
    777 FGG

  7. #7
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    Losing a limb?

  8. #8
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    An infection that is spreading is what I was going for.
    Everything marked, everything 'membered. You wait, you'll see.

  9. #9
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    That's cold.
    777 FGG

  10. #10
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    I would think it would be accompanied by a fever. If it's cold, I think you have worse problems.

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