[pct-l] antibiotics, FAK

[Dan Africk]

I'll be bringing azithromycin, brand name Zithromax, as well as cipro.
They're both broad-spectrum and powerful antibiotics, but the nice thing
about zithromax is that a full course of treatment is only 6 pills(its
available in a 6-pill blister pack, sometimes called a Z-pack). You take 2
on the first day, then 1 pill for 4 days, and you're done. A full course of
treatment for Cipro is usually 7-14 days, and a common dosage is 1 500mg
pill taken 2x day.
I don't know if these drugs are optimum for crypto or giardia, the consensus
seems to be that Flagyl is best for that, but I like that these are
broad-spectrum and can be used for a wide variety of infections. I suspect
that they'd work well for crypto or giardia, but I'd like to hear from
anyone that has specific knowledge about how well they work for this.

I don't plan on taking any antibiotic unless I have overwhelming or very
compelling reasons to believe I have a bacterial infection, and I don't have
access to a doctor or medical testing. Nevertheless I feel much better
carrying antibiotics, knowing that if I get a nasty infection in the
back-country I can treat it right away. For any drug you carry but
especially antibiotics, make sure you read up on side effects, drug
interactions, etc before you leave. For example Cipro increases sensitivity
to sunlight, and can make the effects of caffeine stronger, and may interact
with ibuprofen. On a related note, I read a study a while back that showed
that drinking green tea while taking antibiotics makes the antibiotics up to
3x more effective! Good to know.

If you ever do take an antibiotic, it is very, very, important to finish the
full course of treatment, even if you feel better right away. People not
finishing their antibiotic treatments is one of the reasons we now have
incurable, multiple-antibiotic resistant "superbugs. Scary stuff. One option
for something like cipro is to carry a partial course of treatment, say, 5
days worth, and keep the rest in your bounce box, or have a doctor who will
send out a prescription on short notice.

Evan and Ryan, I'll email you off-list with my full first aid kit inventory.
I have a very different opinion than most about what qualifies as a first
aid kit and what is the minimum you should take, so my FAK is huge by mosts
standards, even after spending a lot of time removing as much as I could
bear to take out. It will probably get smaller after a few weeks on the
trail, but I'll still bet that I arrive in Canada with one of the biggest
FAKs of any thru-hiker.

Some of the other drugs I consider important are diphenhydramine(benadryl),
naproxen and/or ibuprofin(naproxen lasts up to 12 hours vs 4, so is more
weight efficient), loperamide HCL(immodium), and prescription pain killers
if you can get them. I'm also bringing prednisone, a prescription steroid,
in case of a severe reaction to poison ivy/oak, or any severe allergies.
When thinking about bandaging and wound-care supplies, keep in mind that if
you have a serious injury, you may need to change a dressing 2 or more times
a day for several days, or until you reach a resupply point with medical
supplies. I rarely get anything worse than a small cut, but personally I
don't want to have to call for help just because I didn't bring enough
gauze. I consider teflon dressings covered with guaze pads and then secured
with a roll of stretch gauze or vet wrap(kind of like an adhesive,
waterproof ace bandage), to be the gold standard for any wound larger than
what a band-aid will cover(and in that case, your wound will probably heal
faster without the band-aid)


-- 
www.hikefor.com/haiti-2010-Dan