Sunday, 23 October 2016

10:00 – Email from Brittany yesterday, CC’d to Jen. Like many preppers, with only a couple of weeks until the election, Brittany is trying to make sure she has all her ducks lined up.

She’s been reading about fish antibiotics, and wanted to know which specifically I’d recommend she buy RFN. With the usual disclaimer that I am neither a physician nor a pharmacist and so as an unqualified person all I can do is tell her what I would store in her place, I mentioned the following, assuming that neither she nor her family has any allergies to any of these antibiotics:

1. Doxycycline — probably the most flexible of readily-available broad-spectrum antibiotics. The usual adult course of treatment is one 100-mg tablet/capsule every 12 hours for a week to ten days, which means that a bottle of 60 tablets is 30 days’ worth, or three to four full courses. (For a dozen people, I’d keep 12 to 25 courses on hand.)

2. SMZ/TMP — another readily-available broad-spectrum antibiotic. The usual adult course of treatment is one 400/80-mg tablet every 12 hours for a week to ten days, which means that a bottle of 60 800/160-mg tablets is 60 days’ worth, or six to eight full courses. (For a dozen people, I’d keep 12 to 25 courses on hand.)

3. Metronidazole — another readily-available broad-spectrum antibiotic, which is also active against anaerobic bacteria and many protozoal pathogens. Although it varies with the disease being treated, the usual adult course of treatment is 2,000 to 4,000 mg total per day (at 7.5 mg/kg) divided into three or four doses for five to ten days, which means that a bottle of 60 500-mg tablets (30 grams total) is one to two full courses of treatment for a 150-pound adult. (For a dozen people, I’d keep 12 to 25 courses on hand.)

4. Ciprofloxacin — another readily-available broad-spectrum antibiotic. The usual adult course of treatment is one 500-mg tablet/capsule every 12 hours for seven to fourteen days, which means that a bottle of 60 500-mg tablets is two to four full courses. (For a dozen people, I’d keep 6 to 12 courses on hand.)

Although it’s harder to come by than the antibiotics listed above, I’d also want to keep a few courses of 875/125-mg amoxicillin/clavulanate on hand. Resistance to plain amoxicillin is now so widespread that many physicians treat it almost as a placebo, so don’t bother stocking it or other beta-lactam antibiotics.