The smallest enemy.

[wicca]

I've been reading the interesting thread that Bushcraftbob started on natural cleansing agents and just thought while 'medical' matters were in mind that I would bring up the subject of anti-biotics.

People often show first aid kit contents and generally for accompanied trips or short solo forays those kits cover all eventualities, but something that happened to me recently brought home the fact that an addition to any kit used on trips to wilder places, even within UK perhaps should have at least some kind of anti-biotics, scrounged, begged for, or requested nicely.. from the doctor as I believe they're only available on prescription at home.

I was ready to sail from my present location and was anchored out in the harbour awaiting a fair tide to carry me Eastward. Started feeling unwell, shivering, weak and "The eye of a needle" springs to mind. I was able to weigh anchor and move the short distance into a nearby marina. So, a bit of food poisoning I thought, soon beat that....
There followed three days of lying on bath towels to soak up perspiration, drinking litres of liquid and eating nothing. On the forth morning I awoke to find my left leg covered from knee to ankle in a blistered rash which was painfull and so swollen I had a problem pulling my jeans on.

Hospital by taxi, not a pleasant journey,promise you..
Celulitis was the Portugese Doctors diagnosis. A tiny bacteria had somehow entered the skin, possibly a mozzie bite that I had broken (I know not to scratch them...)
Anyway without belabouring the drama, the infection basically decked me for more than a week and although I'm not young I'm not a cuddly bunny, and don't usually fall over when bitten by a microbe.

The Doctor fed me 500 mg anti-biotics resembling small white housebricks and said had I not got to the hospital the consequences could have been dire. Which made me think...
Solo bushy/camping trip somewhere isolated, failure to tell someone return date/ general location and perhaps a mobile phone going down??
Walking out, I promise would not have been an option especially in bad weather. I had trouble standing.

Not preaching, still off for a tab round the mountains when I get a chance, but luckily I can get a basic, broad based anti-biotic over the counter where I'm going. Regards Wicca...

 

[BorderReiver]

That sounds really nasty, good job that you were ashore when it hit.

The problem with pre-emptive antibiotic carrying is the problem of getting the right one to kill the bug that gets you and not you.

Allergic reactions on top of the infection would probably carry you off quicker than letting the infection take it's course.

Topical, broad spectrum antibiotics, with anti fungal agents incorporated would be sensible to have. That relies on you being vigilant and treating scratched mozzie bites and the like before the infection takes hold.

 

[wicca]

Yes, I asked the Doctor about that and he said if I'm not allergic to Penicillin then a simple "broad based" anti-biotic like Amoxicillin 250mg (spelling ?) would be safe to use.

So obviously it would be 'AS advised' by your own doctor as to what you carried. But I reckon if you're out in the boonies with a leg three times the size it should be, glowing hot and feeling as if it's about to burst, and you can't work out it's an infection and anti-biotic time is here...then you shouldn't perhaps be allowed out on your own..

 

[rik_uk3]

In the UK, by the time the antibiotics have kicked in and started working you should already have reached a place of safety and medical treatment so I'd say no to carrying them here. Staying in camp waiting for the AB's to work could prove dangerous if in fact the underlying cause of your problem do not require them and you misdiagnosed yourself.

 

[Mahikan]

A good thread this one. I think it is an important consideration if you are going to travel somewhere that the risk is high of infectious agents, but I think it very worth while to pre-empt any of these nasties by a thorough investigation of what the pathogens are that you are likely to come across and how high is the risk, then a good chat with a doctor or the regional health agency would be a good idea. A good thing to use if you know you've had any kind of open wound and are concerned about infection is to use something called a Dakin's solution http://www.google.ca/search?client=...oe=UTF-8&redir_esc=&ei=cwjHS_vHCY-0sgPrxOD4Cg a good friend of mine who is a doctor (and we've used it in labs) recommended it for any travel and pretty much any pathogen will respond.

Mahikan

 

[malente]

This is a good thread!

I think it never hurts to carry a broadspectrum antibiotic that you know you're not allergic to, e.g. if you have been using one before.

I never knew about Dakin's solution, this sounds good!

ATB

Mike

ps wicca glad you're ok again

 

[wicca]

Improving all the time, but still slightly 'lopsided' thank you Malente..

I fear it was probably ill advised of me to suggest it on this forum, probably really aimed at people who go into the wilderness and can't rely on just walking out (or even hopping out on one leg. ) to get medical assistance..

That Dakins Solution sounds interesting Mahikan, thanks for the 'heads up'

 

[marcusleftthesite]

My old man picked up Celulitis through a crack in his heel and like Wicca he was absolutely ill and could'nt walk properly for a very long time.

 

[leaf man]

Man that does sound horrible. Food for thought, but could prove to be worth the weight.
Top thread i think, and thanks for the link.
Atb
mike

 

[Hangman]

Another problem with anti biotics is the dose and duration - take a too small a dose for not long enough you don't kill all the bacteria, what's left bounces back and is antibiotic resistant too boot.

The drugs are prescription only for a good reason, why do we keep seeing posts here asking about prescription only drugs for 'self treatment' ?

 

[BOD]

Wicca's story resonates with me.

last year a leech bite turned bad (nothing to do with the leech but probably my other foot rubbing against my shin while asleeep) and cellulitis developed.

Anti septics no avail. Leg bursting, dizzy weak etc. Got to a doctor in time.

Carry the pennicilin type antibiotics for these sort of problems

 

[Mahikan]

Wicca & BOD:

Cellulitis a nasty indeed, but a handy tip for you in terms of a natural remedy that can help keep things in check are tea from Meadowsweet (Spirea ulmaria) and/or use a poultice of ground fenugreek seeds, don't really know how or why fenugreek works, but seems to help a ton as a poultice.

Erysipelas is similar to cellulitis and they are often found together, so it can be somewhat difficult to tell them apart, but a topical wash or internal tea of valerian can be helpful there, and other than that I'm afraid I've not much more to offer.

I do agree with the antibiotics statement though. Even a broad spectrum can cause drug resistant bacteria, especially if we don't know what we are dealing with, and dosage is vital as is timing etc. Once we create these super bugs... yikes

 

[wicca]

Thanks Mahikan for the tip. I've only had basic medic training so won't get involved the the rights and wrongs of self administered anti-biotics.

My only reply on that subject could be, there are tens probably hundreds of thousands of people who live within the EEC who regularly buy (without doctor's prescription) and self administer anti-biotics. Anti-biotics are freely available over the counter so I assume a population build up of resistance to their use is unlikely, if it was, why are they still available? As far as I am aware folk on the Continent do not die in droves, nor are they anti-biotic resistant. I can only speak from the evidence of my own experience of my travels. The first question from the Portugese Doctor was.."what anti-biotics have you started?" There seemed to be an expectation on his behalf that with an obviously infected leg, I had at least started to help myself..

That's as far as I'm prepared to comment, except the nice Doctor gave me a full course 16 (1 every 12 hours) of CLAVAMOX DT and said, "Put that in your boat's first aid box, and if you ever get an obvious infection as you had on this occasion, start the course until you can get to medical help"..And I will..

 

[Toddy]

That is such a very valid point Wicca; just because in the UK drugs are prescribed does not mean that self prescription is not common elsewhere.
Might be a result of the NHS

I think if I lived as you do then I too would procure and keep antibiotics and epi pens to hand.

cheers,
Toddy

 

[wicca]

Thank you Toddy. There is a very different approach to self help required if someone is within striking distance or mobile phone range of a call to NHS Helpline or an abandonded Bushy sleeping out session resulting in a quick trip to the local surgery. Under those circumstances of course professional medical advice must be heeded. But sometimes it's necessary for individuals to take responsibility for their own well being and safety, they must do whatever necessary at the time, as there isn't always someone else to make their decisions for them. Poor old Bod will know what I mean I'm sure, but I suspect you do to..

 

[Mahikan]

Wicca, indeed an excellent point for sure and it is a sad fact indeed that there are a ton of people world wide that are self prescribing. The incidents of drug resistant bacteria is also on the rise in frightening statistics - very sad that I see these folks, and sometimes the only alternative to dealing with someone sporting Meth Resistant Staph Aureus who also has maybe diabetes is to amputate (of course not always).

No, people are not dropping in droves because luckily we also still have some of our own resistance and if we pulled the stats out for these folks, I'd suspect they were not dealing with half the nasties you are subject to.

As for you and your particular situation, I agree you'd be wise to carry whatever medication is needed to ensure your own health is secure. I know that up in our far north, the likelihood of getting help during a blizzard that could rage on for a few months and the nearest hospital is over 600 km's away means you need to look after yourself for sure!

 

[ashes1627]

Just tell your doctor what you are doing and that you think you need some anti-biotics, and see what they say.

 

[Mikey P]

Hmmmm....

I think the safest advice I've seen so far is to consult a doctor (preferably one with experience of the area you are travelling to) before thinking about taking antibiotics around with you - and, if they say not to bother, do as they say!

Self prescription of antibiotics puts us on dodgy ground as there are so many factors involved (many of which have been covered above). Yep, the guy who started this thread has his lived saved by antibiotics but the other 99.9% of cases often don't need them.

A number of broad-spectrum antibiotics kill commensal gut flora, which provide protection to the individual (through preventing other nasties becoming established or through exotoxins). Whilst use of broad-spectrum antibiotics may speed recovery of of one illness, diarrhoea and GI issues often follow, which make overall recovery much more difficult and often lead to secondary infections becoming established.

There are many reasons why antibiotics are prescription only and to use them without proper medical advice can open a whole world of pain... They are not the panacea that most people seem to think they are.

 

[Broch]

It depends on where you are going and what you are doing. I agree that in the UK they are rarely needed but using antibiotics is not rocket science; there are basic lists of conditions and you can get away with three antibiotics to deal with the majority. It's the missuse that's the problem not the proper use of them. Remember that Doxycycline that is prescribed willy-nilly as an anti-malaria drug is a very useful antibiotic - respiratory, skin, kidney, ear and other infections and bacterial diarrhoea. You rarely get Delhi belly when you're on Doxycycline

For a recent expedition abroad I just told my doctor where I was going, what I wanted to guard against, and what antibiotics I wanted and he agreed and prescribed them.

One of the problems of them not being easily available in the UK is that people don't finish the course because they want to keep some 'in case'.

I use "First Aid and Wilderness Medicine" by Drs Duff & Gormly as my guide (as well as professional training of course).

Cheers,

Broch

 

[Andy BB]

I've worked and/or lived on 6 continents over the years, and antibiotics over the counter is the norm rather than the exception. Which presumably is the cause of resistant strains. And also presumably why the countries that ban this are fighting a losing battle as the vast majority of the world's population have free access to them, and use them accordingly. However, it does tend to raise an interesting point - and pardon me for the analogy. But would you eat an endangered species if it would save your life, or that of your family? After all, there are about 8 billion people in the world, so your/your family's life is not exactly a species-stopper