What is the shelf life of antiboitics?

#2
Re: What is the shelf life of antiboitics?

Well, the VA pharmacies have a regular policy of issuing meds at up to twice their published shelf life. Antibiotics are controlled substances, so they should be prescribed and labelled with an expiration date. Since I get all my meds from the VA, I am living according to their expiration date policy, and I expect you could too.

But, using an antibiotic under conditions other than specific instructions from a licensed professional medical caregiver is a <span style="font-style: italic">very faulty health care practice</span>. You should repeat that to yourself several times.

Different antibiotics have varying efficacies for various conditions, and using a marginally effective antibiotic can be a very effective way to breed resistant infectious organisms.

We have more than enough experience with such things in our household and you <span style="font-style: italic">don't</span> want to repeat our experiences. For example, my Wife spent several weeks in an ICU, in a coma, due to such an organism (VRSA- Vancomycin Resistant Staph Aureas), and I had to return to the Cardiac ICU for several weeks following open heart surgery due to another (MRSA-Methicillin Resistant Staph Aureas)).

Antibiotics, beyond OTC triple antibiotic ointments, have no place in a first aid regimen.

Further, anyone who puts together a first aid kit with the intention of leaving it unchecked and unrefreshed for lengthy periods has no business building a first aid kit. Buy the best general purpose kit you can find, trust the folks who designed it, and replace it every year. Now that's an investment you can live with.

Greg
 
#3
Re: What is the shelf life of antiboitics?

I can't find my references offhand, but the military had the same question a number of years ago, since they do stockpile antibiotics, pain meds, etc. Strikes me that they found that there is a rather extensive shelf life ( 2-3 years beyond the labeled expiration date) for antibiotics as long as they are stored in a controlled environment; i.e., low humidity, room temp or cooler and out of direct sunlight. That is all theoretical however and I have to agree with the previous poster - storing and using meds beyond their prescribed and recommended shelf life is potentially fraught with major problems.
 
#5
Re: What is the shelf life of antiboitics?

And I kinda prefer to have both antibiotics and painkillers available. Most if not all phamacuticals are good for several years after their expiration date, but as Greg suggests, its also good to know what you're taking and for what condition. Get yourself a good medical reference book and proceed with caution. FYI - unlike most antibiotics, Tetracycline compounds can become toxic if held much beyond their expiration date.
 
#7
Re: What is the shelf life of antiboitics?

Been a pharmacist for many years (1980) and definitely tread cautiously here. Medication is typically at 95% effectiveness at or after it's exp date, but temperature/humidity can have drastic effects on it's potency. Fortunately, few meds become dangerous chemically after expiration, but special situations exist, such as tetracycline. You used to be able to buy tetracycline, 250mg, Zenith manufacure, in the pet section of Wal-Mart, for putting in fish tanks!
If medications are part of your kit, certainly keep them separate from the rest of the first aid supplies, rotate them regularly, and be particular about the storage conditions.
If anyone ever has a question, do not hesitate to message me.

Edwin
 
#8
Re: What is the shelf life of antiboitics?

Not a pharamacist, doctor, or lawyer, but I have heard from people like that that most meds, including antibiotics, for the most part, last long as balls. Maybe not if they're stored in your car trunk in TX or Arizona for 5 years. But some multiple of the expiration date. I think everyones treading carefully so they don't get sued but yeah, what the f-ck do I know, but I think they keep a pretty goddamn long time. By the time they stop working, you'll have other problems.
 
#9
Re: What is the shelf life of antiboitics?

I have used pain killers that were about 5 yrs old and still effective. The same thing with antibiotics. My doctor prescribed antibiotics upon request so that I can have them with me when I begin to experience symptoms of prostate infection or kidney.
He has no problem doing this since a lot of times my flare ups have occurred while out of town. This prevents me from being hospitalized.
 
#10
Re: What is the shelf life of antiboitics?

I prescribe rx's every day all day long. I can tell you what I travel with all the time.

First if it is in the wilderness, I have a field surgical kit which I have carried since 5th SFGA days in the early 70's. It has a small assortment of hemostats, would probes, kelly clams.
For expendables in it, I have numerous 25 guage long needles and syringes with carbocaine anasthetic, (No epinephrine). That way you can use it for any wounds. Then I have numerous packs of needles and suture (ethicon with a f2S cutting needle). These you can use to suture yourself closed. Then the usual alcohol wipes and telfa bandages, and ace wraps and some tape. Maybe a few tampons too.
For antibiotics, I always have Cipro, Zithromax, Keflex, Augmentin, Duricef. These will cover any strain you have to deal with. The most difficult part is determining what you are treating.
For pain meds I keep Vicodin ES, and Percocet and plenty of Ibuprofin.
Another handy item to have in your kit would be a Sanford pocket guide to antibiotics and diseases and symptoms.
The antibiotics will last for years after the expiration date. I tend to use them periodically so I find that they are never more than two years past the date I replenished them.
 
#11
Re: What is the shelf life of antiboitics?

I would be careful as Edwin has said!
There is a reason that drug resistant strains exist and that is the result mostly of people not following directions!

If it is expired I usually rebuy unless it is IV's and then I look for floaty's if non are good and it is within 1 year of expiration date then I consider it as good.

Part of the things is that you need to constantly check your med kits! This is not a fire and forget for 20 years thing.
 
#13
Re: What is the shelf life of antiboitics?

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: spotswood</div><div class="ubbcode-body">I prescribe rx's every day all day long. I can tell you what I travel with all the time.

First if it is in the wilderness, I have a field surgical kit which I have carried since 5th SFGA days in the early 70's. It has a small assortment of hemostats, would probes, kelly clams.
For expendables in it, I have numerous 25 guage long needles and syringes with carbocaine anasthetic, (No epinephrine). That way you can use it for any wounds. Then I have numerous packs of needles and suture (ethicon with a f2S cutting needle). These you can use to suture yourself closed. Then the usual alcohol wipes and telfa bandages, and ace wraps and some tape. Maybe a few tampons too.
For antibiotics, I always have Cipro, Zithromax, Keflex, Augmentin, Duricef. These will cover any strain you have to deal with. The most difficult part is determining what you are treating.
For pain meds I keep Vicodin ES, and Percocet and plenty of Ibuprofin.
Another handy item to have in your kit would be a Sanford pocket guide to antibiotics and diseases and symptoms.
The antibiotics will last for years after the expiration date. I tend to use them periodically so I find that they are never more than two years past the date I replenished them. </div></div>

This maybe the worst advice in a thread that a physician could ever give. Numerous mistakes... Besides spelling mistakes, Ethicon is a name for a company, not a type of suture. If someone was going to repair a wound in the field, a braided suture (silk, Ticron, Ethibond, etc...) would be a better choice, and it would be much easier to use a straight needle if you aren't comfortable with suturing techniques. A long 25 gauge needle to inject local anesthetic isn't a good choice either. A 25 gauge needle will be difficult to use for the injection and a long needle used to inject Carbocaine by someone not trained to use this medication could lead to intravenous injection, which could be rapidly fatal. Recommending someone acquires that list of antibiotics and uses them is really strange. That list has multiple overlaps in coverage and could lead to dangerous interactions, and possible drug resistance. The pain medication recommendations are even more alarming for a health professional. How about Motrin/Advil, before recommending restricted narcotics? Why not just recommend Fentanyl lollipops?

CWJ
 
#14
Re: What is the shelf life of antiboitics?

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Robozebra</div><div class="ubbcode-body">Why not just recommend Fentanyl lollipops?

CWJ
</div></div>

How hard is it to get Fentanyl lollipops? We had them when I was deployed in Iraq with the Marines and they were great for the field!! Not too worried about them breaking and easy to use. Unfortunately I haven't been able to get them or even find anyone that even knows about them while working over in Iraq as a medic. It seems to me that we have gone overboard with enforcement of Narcotics that people are so paranoid about them. Not that they should be handed out like candy.
 
#15
Re: What is the shelf life of antiboitics?

"Fortunately, few meds become dangerous chemically after expiration, but special situations exist, such as tetracycline. You used to be able to buy tetracycline, 250mg, Zenith manufacure, in the pet section of Wal-Mart, for putting in fish tanks"

Tetracycline is still very easy to come by. In powder form the carrier goes bad. In liquid form I don't know what causes it, carrier, I use 2 different ones both have different carriers.
 
#17
Re: What is the shelf life of antiboitics?

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Robozebra</div><div class="ubbcode-body"><div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: spotswood</div><div class="ubbcode-body">I prescribe rx's every day all day long. I can tell you what I travel with all the time.

First if it is in the wilderness, I have a field surgical kit which I have carried since 5th SFGA days in the early 70's. It has a small assortment of hemostats, would probes, kelly clams.
For expendables in it, I have numerous 25 guage long needles and syringes with carbocaine anasthetic, (No epinephrine). That way you can use it for any wounds. Then I have numerous packs of needles and suture (ethicon with a f2S cutting needle). These you can use to suture yourself closed. Then the usual alcohol wipes and telfa bandages, and ace wraps and some tape. Maybe a few tampons too.
For antibiotics, I always have Cipro, Zithromax, Keflex, Augmentin, Duricef. These will cover any strain you have to deal with. The most difficult part is determining what you are treating.
For pain meds I keep Vicodin ES, and Percocet and plenty of Ibuprofin.
Another handy item to have in your kit would be a Sanford pocket guide to antibiotics and diseases and symptoms.
The antibiotics will last for years after the expiration date. I tend to use them periodically so I find that they are never more than two years past the date I replenished them. </div></div>

This maybe the worst advice in a thread that a physician could ever give. Numerous mistakes... Besides spelling mistakes, Ethicon is a name for a company, not a type of suture. If someone was going to repair a wound in the field, a braided suture (silk, Ticron, Ethibond, etc...) would be a better choice, and it would be much easier to use a straight needle if you aren't comfortable with suturing techniques. A long 25 gauge needle to inject local anesthetic isn't a good choice either. A 25 gauge needle will be difficult to use for the injection and a long needle used to inject Carbocaine by someone not trained to use this medication could lead to intravenous injection, which could be rapidly fatal. Recommending someone acquires that list of antibiotics and uses them is really strange. That list has multiple overlaps in coverage and could lead to dangerous interactions, and possible drug resistance. The pain medication recommendations are even more alarming for a health professional. How about Motrin/Advil, before recommending restricted narcotics? Why not just recommend Fentanyl lollipops?

CWJ
</div></div>

Intravenous local anesthetic is not rapidly fatal, unless you inject a ton of it.
 
#19
Re: What is the shelf life of antiboitics?

I practice in a pain management practice. We used to prescribe Actiq (fentanyl pops), when it was first introduced, and we regreted it. These things are like crack in that they are HIGHLY addictive and the bodies ability to develop the need for more is nearly instant. I wouldnt touch that shit if I were you. Great for the field?
<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Jong</div><div class="ubbcode-body"><div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Robozebra</div><div class="ubbcode-body">Why not just recommend Fentanyl lollipops?

CWJ
</div></div>

How hard is it to get Fentanyl lollipops? We had them when I was deployed in Iraq with the Marines and they were great for the field!! Not too worried about them breaking and easy to use. Unfortunately I haven't been able to get them or even find anyone that even knows about them while working over in Iraq as a medic. It seems to me that we have gone overboard with enforcement of Narcotics that people are so paranoid about them. Not that they should be handed out like candy. </div></div>
 
#20
Re: What is the shelf life of antiboitics?

I apologize for the typos. I was not wearing my glasses and I am not a typist and it was late and I was tired.

The antibiotics are overlapping but those will cover most everything you will encounter. Some are stronger than others and you could choose based on the severity of the problem you are treating.
Regarding suture material, I was too lazy to type everything but I meant Ethicon sterile packets of which I use a vicryl material with the needles attached. If you can sew a button, you can sew a wound. It is not rocket science.
As stated it is safe to use anasthetic. I do not use epinephrine in my kit for wounds so there is no sloughing of the tissue. Even with epinephrine in it, you do not have to worry about intra vascular injections as the result would just be an increase in heart rate for a while.
For needles, I actually carry two. I meant to say 27 guage long that are 1 1/2 inches long and 30 guage which are 1 inch long.
There is nothing dangerous about anything I carry or use.
I would pass on the fentanyl lollipops though.
 
#21
Re: What is the shelf life of antiboitics?

Guys thanks for the responses, I was not looking for sugar coated politically correct answers, like some offered, but real life hard use advice. I am putting together a SHTF first aid kit
should I need to rely on my self for survival.

Common sense dictates not to inject topical anesthetic into a vein. But to some, common sense is not all that common. But in a bad situation, if you had to be stitched up, would you care if it was done with braided or non-braided suture? Or if medical personnel were otherwise unavailable - and someone was suffering from an infection, would they care if you only had Cipro or Flagyl?

Spotswood - exactly - with a little bit of prior research and a little bit of practice one can get themselves out of bad situations - its not rocket science.
I would love to have a discussion on field and emergency first aid techniques- and a suggestion of contents for a Shit Hit the Fan EFA Kit.

Someone mentioned that certain components need to be rotated regularly. This is one of my questions, are there general purpose antibotics that can work well in most situations in order to keep the overall inventory down, ie Cipro?

I am not creating my own first aid kit for everyday use - this is a precaution for a extraordinarily bad situation.





 
#22
Re: What is the shelf life of antiboitics?

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: palmik</div><div class="ubbcode-body">
Intravenous local anesthetic is not rapidly fatal, unless you inject a ton of it. </div></div>

Depends on the local anesthetic. It takes a big dose of lidocaine to get cardiac arrhythmias, but it doesn't take that much of other anesthetics. I've seen complete heart block with 10 ml of 0.25% Marcaine injected IV. (EP Fellow before me in training.) You think people would know not to inject anesthetics IV, but it can happen, especially with very small bore needles where you don't get a great flash when pulling it back. I use a 22 gauge when I inject local anesthetic in the central portion of the body. If I were suturing on a limb, maybe I'd use a smaller bore needle, but I would use a shorter needle in those cases to aid in stiffness.

CWJ
 
#23
Re: What is the shelf life of antiboitics?

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: spotswood</div><div class="ubbcode-body">I apologize for the typos. I was not wearing my glasses and I am not a typist and it was late and I was tired.

<span style="font-weight: bold">I was just "busting your balls" on that part. Sorry..</span>


The antibiotics are overlapping but those will cover most everything you will encounter. Some are stronger than others and you could choose based on the severity of the problem you are treating.

<span style="font-weight: bold">The problem is that you really shouldn't try to figure out which antibiotic to use on your own, unless you are educated on those agents. I had a lot of medical school classmates that couldn't figure it out, much less laymen.</span>


Regarding suture material, I was too lazy to type everything but I meant Ethicon sterile packets of which I use a vicryl material with the needles attached. If you can sew a button, you can sew a wound. It is not rocket science.

<span style="font-weight: bold">It's not rocket science, but you can really screw things up if you don't know what you are doing. If it's a small "skin tear" on your arm, you could probably close it without doing any damage, but if it's a significant wound, you could cause significant skin necrosis if you closed the wound incorrectly. Why not just use steri-strips to approximate the skin tear until it can be closed by someone properly trained.</span>


As stated it is safe to use anasthetic. I do not use epinephrine in my kit for wounds so there is no sloughing of the tissue. Even with epinephrine in it, you do not have to worry about intra vascular injections as the result would just be an increase in heart rate for a while.

<span style="font-weight: bold">That really depends on the anesthetic and how it's injected. Arrhythmias with local anesthetics are usually heart block, or ventricular arrhythmias, not sinus tachycardia.</span>


For needles, I actually carry two. I meant to say 27 guage long that are 1 1/2 inches long and 30 guage which are 1 inch long.
There is nothing dangerous about anything I carry or use.
I would pass on the fentanyl lollipops though. </div></div>
 
#24
Re: What is the shelf life of antiboitics?

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Tomcat</div><div class="ubbcode-body"> But in a bad situation, if you had to be stitched up, would you care if it was done with braided or non-braided suture?

<span style="font-weight: bold">Braided and non-braided suture are completely different sutures, and have a different feel when suturing with them. Lacerations in certain areas (oral), are better closed with certain sutures. Common skin lacerations are usually better closed with an absorbable suture (like Vicryl), whether in an interrupted or running fashion. The reason that I wouldn't recommend that someone not trained in wound closure, carry suture with the purpose of closing wounds is that some wounds require different techniques (multi-layer closures). Also, closing wounds that aren't completely cleaned can result in bad infections. I'd recommend cleaning the wound as thoroughly as possible and then re-approximating the skin with steri-strips over suturing wounds.</span>


Or if medical personnel were otherwise unavailable - and someone was suffering from an infection, would they care if you only had Cipro or Flagyl?

<span style="font-weight: bold">Depends on the infection.

Another thought on giving someone else an antibiotic, what happens if they have an anaphylactic reaction? Are you going to be prepared? I have several patients that couldn't tell you their allergies without a cheat sheet. And, do you know all of the antibiotics in different families? Some reactions are class reactions...

I think if I was going to carry one antibiotic that would be my "go to" if I got a bad infection while in the wilderness, it would be either Augmentin or Levaquin for most infections, and Flagyl for GI infections. I'm not advocating that you use those by any means though... I'd use those for me, and only me (or my wife)...</span>
</div></div>
 
#25
Re: What is the shelf life of antiboitics?

1st ampicillin, has widest range of use, pretreatment with absorption blockers, (pepto bismol) will treat lower intestinal problems, regular upper lung and urinary tract. 2nd. choice high doses of cephalexin for short periods (burst dosing) will cut open wound healing time in half. Better soft tissue distribution than amp. (sinus areas) Cross sensitivity to penicillin allergies in about 10% of the population. 3nd. Amoxicillin or Augmentin,Augmentin has a really short shelf life in all dosage forms, against wide range of organisms 3rd. - some metronidazole would be nice while your at it for larger water born organisms. Pack well with Silica Gel or comparable, in good sealed containers.
More organisms become resistent to antibiotics from sources of TCN (tetracycline) and ciprofloxin in cattle feed than thru the human cycle.
Don't forget as to store as much Betadine, and Clorox (effective against all topical fungus as well as large container water purification) as possible.
Try to get injectable ketorolac which works almost as good as morphine on certain types of injuries (kidney stones) anything else will be Schedule II and lots of problems if you need to explain it. If you want to mess with schedules use Stadol, either nasal (easiest to store) or inj.
 
#26
Re: What is the shelf life of antiboitics?

If you want to treat allergic reaction, use inj. benadryl, if possible, if not treat as soon as possible with 200-300 mg of tagamet, benadryl and anyother h2 blockers you have hanging around. follow up with prednisone in taper dose. You should have prednisone in your "pack" for other reasons as well.
 
#27
Re: What is the shelf life of antiboitics?

While the down in the weeds stuff that is being mentioned in the above posts are nice........if you have to ask you don't have the need. Antibiotics are a handy thing if you know what your about but if you don't you can seriously screw someone up. Anybody remember that there is a 10% PCN crossover for Z-MAx? Yeah, that will put a clamp on your happy day. You may kill the bug but the PT will be sucking A$$ too.

FWIW you could invite your MD to a local imbibery and discuss the medical history of your family and logical acquaintances. From that point you could deliberate upon the needs of a well stocked medical kit for your "tropical sailing expedition". Given a viable need and explanation most reasonable MD's will provide you prescriptions for the medical OH SHITS you might encounter. Prescriptions become handy when you happen to cross those pesky border guards and other badge wearing types that may ask the question of why you have 5 syringes of Morphine and a similar amount of Valium in your FAK.

As far as suture, IF it needs sewing your pretty much screwed. I speak Durilon, Ethibond, Ethilon, Vycril, Proline and a whole host of others down to and including "Gut" (yes they still make it and it comes in a yellow package). As was stated above if you don't have sufficient knowledge of anatomy you have no need to be running a needle driver. If you do, you know how much effort it takes to get a field wound ready to sew. Granulation looks like hell and takes a while but it keeps the bugs outside.

Survival medicine is as much about conservation of limited resources as it is about saving the patient. A couple shots of Jack Daniels and a couple .45 rounds may be the best medicine. Just say'n.

Cheers,

Doc
 
#28
Re: What is the shelf life of antiboitics?

I've been a Board Certified Physician for over 30 years. I'm Chief of Internal Medicine at a hospital that serves over 18,000 patients a year. I've wrote and published 7 books on the subject and was voted Doctor of the Year 9 times by my peers over the years I've been practicing. The best advice I can give on this subject is............

Rub some dirt in that shit and walk it off!!!!


p.s. Just kidding about the credentials :)
 
#29
Re: What is the shelf life of antiboitics?

I really need and would love to take a course in emergency medicine. Topics could include:

Shock management
Fluid loss and replacement
Wound care cleaning and closure
Trauma care - broken bones
Post wound care - infection management
Pain management


It would be great if there were such a thing, but it only exist in books. No on will teach anything for liability reasons.

Does anyone know of any materials on these topics? What are the other topics one should become familiar with?
 
#30
Re: What is the shelf life of antiboitics?

Well if you are just looking for books you can probably find online the special operations medical handbook or the ranger medical handbook. There are classes but mostly for military or people that have a need to learn operational type medicine.
 
#31
Re: What is the shelf life of antiboitics?

<div class="ubbcode-block"><div class="ubbcode-header">Originally Posted By: Tomcat</div><div class="ubbcode-body">I really need and would love to take a course in emergency medicine. Topics could include:

Shock management
Fluid loss and replacement
Wound care cleaning and closure
Trauma care - broken bones
Post wound care - infection management
Pain management


It would be great if there were such a thing, but it only exist in books. No on will teach anything for liability reasons.

Does anyone know of any materials on these topics? What are the other topics one should become familiar with?</div></div>
You can pick up anything you'd really need in a con-ed EMT-B course at your local community college for less than $300 in most states. Anything beyond the ABCs plus splinting/C-spine you wouldn't want to mess with in the field. But if your thinking an end-of-world-as-we-know-it situation and you really needed to stitch someone up or decompress a chest cavity in a survival situation just keep the Special Operations Forces medical book handy. It's all there, from surgery to pharma and no one will likely be concerned about a lawsuit if things are that dicked up, anyway.

Oh, and if you just have to practice stitches ask your local pig farmer if you can practice at hog killin time.

Edit ... make sure you get the latest version of the SOF Medical Handbook, <span style="font-weight: bold">not </span>the old SF Medical book 31-91B, which has been <span style="font-style: italic">seriously </span>superseded.
 
#32
Re: What is the shelf life of antiboitics?

There is some good advice here and some very bad advice as well. "Common sense dictates not to inject TOPICAL anesthetic into a vein" WTF.
I thought the reloading section had some scary stuff.
 
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