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Top five antibiotics to keep in your travel first aid kit
Back alley eateries aside, experienced adventurers know that it pays to visit a travel medicine clinic or their primary physician (an internist is best) before heading off the beaten path. I've learned through painful, sometimes embarrassing, experience to take a portable pharmacy with me when I travel, so I'm prepared when disaster strikes. Checking the Centers for Disease Control and Prevention site is a must when planning a trip to developing nations, so you can get the appropriate immunizations; plan far ahead, as some of these require months to take effect.
Please note that I'm not endorsing self-diagnosis, the purchase of dubious or over-the-counter pharmaceuticals, or the casual use of antibiotics. You can buy OTC meds in many countries, and I've had to do so more than once. But I wouldn't recommend it unless it's an emergency, you can't get to a doctor, or the only medical assistance available is more high-risk than trying to diagnose and treat yourself.
Get legal prescriptions from your own doctor, one who hopefully understands tropical and/or travel medicine. Carry paper copies of your prescriptions with you, in case you find yourself subject to a random bag search (because life in a Thai prison isn't fun, no matter what anyone tells you). For this reason, I don't carry sterile syringes or hypodermic needles in my first-aid kit. If you're diabetic or have a medical condition that requires injections, be sure to wear a medical alert bracelet and carry the appropriate paperwork on your person at all times.
I carry a small, nylon, wilderness first aid kit in my backpack. Besides the usual OTC stuff-hydrocortisone cream, antibiotic ointment, Airborne, ibuprofen, antihistamines, Imodium, and Pepto-Bismol tablets, my top five must-haves are listed below. Obviously, your list and doseages will vary based on your individual needs (I'm allergic to Penicillin), and you need to be extremely cautious about potential drug interactions, which is why you need a doctor to prescribe this stuff. All of these drugs are available in less-expensive generic forms.
1. Cipro: The big gun for serious bacterial infections
2. Doxycycline: a less expensive, less hardcore drug for bacterial infections, or for use in combination with other drugs for amoebic infections
3. Erythromycin: used for respiratory and streptococcal infections
4. Flagyl (metronidazole) for anaerobic bacterial, and certain parasitic infections
5. Gentomycin: an antibiotic eye ointment for stys, conjunctivitis, or other infections
6. Bonus round for women: Bactrim (for UTI's, but also useful for GI infections), and Diflucan or Terazol (for yeast infections). If you're traveling in the tropics or are withholding water consumption due to logistics (say, a 15-hour trip on a bus that has no toilet), you'll be glad you have these on you. Trust me.
[Photo credit: Flickr user DawnVGilmorePhotography]