Emergency

Antibiotic
Guide
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 P R E FAC E
As a primary care physician, prescribing antibiotics for
various bacterial infections is an everyday occurrence in
my practice. Antibiotics are vital to our health and safety.

One hundred years ago, the top 5 causes of death in

America were gastrointestinal infections, tuberculosis,
pneumonia, heart disease, and kidney failure (usually
related to untreated bacterial infections or poisoning).
Since then, advances in medical knowledge, including
therapeutics such as antibiotics, have transformed life as
we know it, and infections are no longer a top cause of
death. However, bacterial infections are still a significant
killer in many developing nations, with pneumonia and
diarrheal illnesses near the top.

What would happen if you found yourself cut off

from modern medical care? Or, when you went to the
pharmacy to pick up a prescription for an antibiotic there
was nothing left on the shelves? Unfortunately, in such
scenarios, bacterial infections will once again become top
killers.
In 2004 the last manufacturer in the United States
to produce critical ingredients for antibiotics was
closed. At the time, few were worried about the
closure from a national security perspective. However,
today conservative estimates show that over 80% of
key ingredients used to make medications in the US
are produced overseas, many in China. Thus, from
geopolitical instability to natural disasters and global
pandemics, the potential threat of US citizens not having
access to life-saving medications is real.

This guide is not intended to be an all-inclusive

pharmaceutical guide to disease, infections, or
medications. Instead, it should be used (along with other
more complete texts) as a reference when access to
prompt medical attention may not be possible.

The listed infections were selected as the most likely to

be encountered in remote locations or austere conditions
and those that would be crucial in a bioterror scenario.
Whether you are out on an extended adventure or find
yourself and your family quarantined to your home due
to a global pandemic or bioterror attack, this guide and
the accompanying medications it refers to may be the
difference between life and death.

Shawn Rowland, M.D.

JASE Medical
BEFORE TAKING ANY OF THESE MEDICATIONS
YOU SHOULD CONSULT WITH A HEALTHCARE
PROFESSIONAL WHENEVER POSSIBLE.

Depending on reported allergies and your physician’s

specific prescriptions, your kit contains some, but not all,
of the following medications.

• Amoxicillin-Clavulanate 875 mg tablets

• Azithromycin 250 mg tablets
• Ciprofloxacin 500 mg tablets
• Doxycycline 100 mg capsules
• Fluconazole 150 mg tablets
• Metronidazole 500 mg tablets
• Nitrofurantoin 100 mg capsules
• Ondansetron 4 mg tablets
• Sulfamethoxazole/Trimethoprim 800/160 mg
tablets

Be aware that the shelf-life of most solid oral

medications is optimized at room temperature 68-77F
(20-25C) and when protected from UV light. Whenever
possible store medication in a cool, dark & dry place. For
more information, see Appendix B.
 CONTENTS
BY DRUG
Amoxicillin-Clavulanate 01
Used to treat:
Bite wounds (animal or human)
Pneumonia (in combination with
Azithromycin or Doxycycline)
Sinusitis

Azithromycin 04
Used to treat:
Pneumonia
Traveler’s diarrhea
Urinary tract infection Traveler’s
diarrhea

Ciprofloxacin 06
Used to treat:
Anthrax exposure and infection (bioterror)
Plague exposure and infection (bioterror)
Traveler’s diarrhea
Tularemia (bioterror)
Doxycycline 11
Used to treat:
Anthrax (bioterror)
Bites (animal and human)
Plague (bioterror)
Skin infection
Tetanus
Tularemia (bioterror)

Fluconazole 16
Used to treat:
Vaginal candidiasis

Metronidazole 18
Used to treat:
Bacterial vaginosis
Diarrhea (caused by Giardia and
Clostridioides difficile)
Giardiasis
Tetanus
Trichomoniasis
Nitrofurantoin 22
Used to treat:
Urinary Tract Infections (UTIs)

Ondansetron 24
Used to treat:
Nausea and vomiting

Sulfamethoxazole/Trimethoprim 26
Used to treat:
Bite Wounds
Urinary Tract Infection (UTIs)
 CONTENTS BY
CONDITION
Anthrax
Medication: Ciprofloxacin 06
Doxycycline 11

Bacterial vaginosis
Medication: Metronidazole 18

Bites (Animal or Human)

Medication: Amoxicillin-Clavulanate 01
Doxycycline 11
Sulfamethoxazole 26
\Trimethoprim

Clostridioides Difficile
Medication: Metronidazole 18

Giardiasis
Medication: Metronidazole 18

Nausea\Vomiting
Medication: Ondansetron 24
Plague (bioterror)
Medication: Ciprofloxacin 06
Doxycycline 11
Pneumonia
Medication: Amoxicillin-Clavulanate 01
Azithromycin 04
Doxycycline 11
Sinusitis
Medication: Amoxicillin-Clavulanate 01

Skin infection
Medication: Doxycycline 11

Tetanus
Medication: Doxycycline 11
Metronidazole 18
Traveler’s Diarrhea
Medication: Azithromycin 04
Ciprofloxacin 08
Trichomoniasis
Medication: Metronidazole 18
Tularemia (bioterror)
Medication: Ciprofloxacin 06
Doxycycline 11

Urinary tract infection

Medication: Ciprofloxacin 06
Sulfamethoxazole 26
/Trimethoprim
Nitrofurantoin 22

Vaginal candidiasis
Medication: Fluconazole 16

AMOXICILLIN-CLAVULANATE
875 mg/125 mg
(dose is based on the amoxicillin component)

CAUTION - Amoxicillin is a beta-lactam type antibiotic

in the same category as penicillin and cephalosporins.
DO NOT TAKE IF YOU ARE ALLERGIC TO PENICILLIN OR
CEPHALOSPORINS (like cephalexin/Keflex).

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - Pregnancy Risk Category B (see table in

Appendix A)

BREAST-FEEDING - Considered compatible with

breastfeeding when used in usual recommended doses.

NOTES - May be taken with meals or on an empty

stomach. Take with meals to help with increased
absorption and decrease upset stomach.

Used to treat bite wounds (animal or human), pneumonia

(in combination with Azithromycin or Doxycycline),
sinusitis, amongst other uses.

Emergency Antibiotic Guide - JASE Medical 01

Bite Wounds
Any kind of wound, including bite wounds, should be
thoroughly cleaned. Consult your preferred first-aid manual
for instructions on how to properly clean bite wounds.
Used to prevent infection after an animal or human bite as
well as to treat wounds that may already be infected after
an animal or human bite.

Take ONE tablet by mouth TWICE per day.

To PREVENT infection, continue for 3-5 days.
To TREAT an infection, continue for minimum of 5
days up to 14 days.

Pneumonia
Without the aid of a chest x-ray or blood tests you must
rely solely on signs and symptoms to help determine if
pneumonia is present; such as fever, chills, chest pain that
worsens with inspiration and/or expiration, shortness of
breath, and a cough that produces sputum. Amoxicillin-
clavulanate can be taken in conjunction with either
azithromycin or doxycycline to cover most common
causes of pneumonia.

Take ONE tablet by mouth TWICE per day for 5 days

with EITHER:
Azithromycin 250 mg, take TWO tablets by mouth on
day 1 and ONE tablet on days 2-5. or
Doxycycline 100 mg, take ONE capsule by mouth
TWICE per day for 5 days.

02 Emergency Antibiotic Guide - JASE Medical

Sinusitis
For otherwise healthy individuals who have been
experiencing purulent nasal discharge/drainage for less
than 4 weeks that may also be accompanied by pain or
pressure around the face or head.

Take ONE tablet by mouth TWICE per day for 14

days.

Emergency Antibiotic Guide - JASE Medical 03

AZITHROMYCIN 250 mg
CAUTION - Azithromycin belongs to the macrolide class
of antibiotics. DO NOT TAKE if you have a hypersensitivity
or allergy to azithromycin, erythromycin, or any other
macrolide.

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - Pregnancy Risk Category B (see table in

Appendix A)

BREAST-FEEDING - Present in breastmilk. Monitor infants

for GI disturbances.

NOTES - May be taken with meals or on an empty stomach.

Take with meals to help with increased absorption and
decrease upset stomach.

Used to treat pneumonia and traveler’s diarrhea among

other infections.

04 Emergency Antibiotic Guide - JASE Medical

Pneumonia
Without the aid of a chest x-ray or blood tests you must
rely solely on signs and symptoms to help determine
if pneumonia is present; such as fever, chest pain that
worsens with inspiration and/or expiration, shortness of
breath, and a cough that produces sputum. Azithromycin
can be taken in conjunction with amoxicillin clavulanate to
cover most common causes of pneumonia.

Take TWO tablets by mouth on Day 1 and ONE tablet

on Days 2-5 with
Amoxicillin-Clavulanate 875 mg, take ONE tablet by
mouth TWICE per day for 5 days.

Traveler’s Diarrhea
There are many possible causes of diarrhea such as
parasitic, viral, and bacterial sources of infection. Traveler’s
diarrhea is defined as diarrhea that develops in individuals
from resource-rich setting during or within 10 days of
returning from a resource-limited region. In these regions,
bacterial causes are the most common. Most episodes
of traveler’s diarrhea are self-limited and not often severe.
However, the accompanying dehydration can complicate
the illness and can pose a more dangerous health hazard
than the diarrhea itself.

Take TWO tablets by mouth ONCE per day for 3 days.

Emergency Antibiotic Guide - JASE Medical 05

CIPROFLOXACIN 500 mg
CAUTION - Ciprofloxacin belongs to the fluoroquinolone
class of antibiotics. DO NOT TAKE if you have a
hypersensitivity or allergy to ciprofloxacin. EXERCISE
CAUTION if taking with anticoagulant medication such as
WARFARIN (COUMADIN).

US BOXED WARNING ABOUT FLUOUOQUINOLONES –

see appendix D

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - Based on available data, an increased

risk of major birth defects, miscarriage, or other adverse
fetal and outcomes have not been observed following
ciprofloxacin use during pregnancy. FDA Pregnancy Risk
Category C (see table in Appendix A).

BREAST-FEEDING - Ciprofloxacin is present in breast

milk, however the relative infant dose is well within limits
considered acceptable.

NOTES - May be taken with or without food, however,

caution should be exercised if consuming calcium-rich
products alone.

Used to treat anthrax exposure and infection, plague

exposure and infection, traveler’s diarrhea, tularemia, and
urinary tract infection.

06 Emergency Antibiotic Guide - JASE Medical

Anthrax (bioterror) Exposure
Consult local health officials for event-specific
recommendations.

Inhalation anthrax results from the inhalation of B.

anthracis spore-containing particles. The incubation
period for inhalation anthrax is estimated to be 1 to 7 days.
However, there are reports that show it may be as long
as 43 days. In 2001 there was a bioterror event with 4 to
6 days elapsing from exposure to symptom onset. It is
imperative that treatment be started if there is a chance of
true exposure because within days after symptoms first
appear, if left untreated, inhalational anthrax disease is
nearly 100% fatal.

For post exposure prophylaxis take ONE tablet by

mouth TWICE per day for 60 days.

Plague (bioterror) Exposure

Consult local health officials for event-specific
recommendations.

For post exposure prophylaxis take ONE tablet by

mouth TWICE per day for at least 14 days and until 2
days have passed without fever.

Emergency Antibiotic Guide - JASE Medical 07

Traveler’s Diarrhea
(as an alternative medication to Azithromycin)

There are many possible causes of diarrhea such as

parasitic, viral, and bacterial sources of infection. Traveler’s
diarrhea is defined as diarrhea that develops in individuals
from resource-rich setting during or within 10 days of
returning from a resource-limited region. In these regions,
bacterial causes are the most common. Most episodes
of traveler’s diarrhea are self-limited and not often severe.
However, the accompanying dehydration can complicate
the illness and can pose a more dangerous health hazard
than the diarrhea itself.

Take ONE tablet by mouth TWICE per day for 3 days.

08 Emergency Antibiotic Guide - JASE Medical

Tularemia (bioterror)
Consult local health officials for event-specific
recommendations. Tularemia has also been identified
as a possible bioterror agent. Symptoms include a fast
onset of fever, chills, fatigue, headache, lymph node
enlargement, eye pain, light sensitivity, or sore throat or
cough approximately 3-5 days after exposure. In a bioterror
related event the airborne transmission of tularemia is
of highest concern. Ciprofloxacin is an ALTERNATIVE
medication for mild to moderate cases.

Take ONE tablet by mouth TWICE per day for

14 days.

Emergency Antibiotic Guide - JASE Medical 09

Urinary Tract Infection (simple and
complicated)
Signs and symptoms of a urinary tract infection
include burning with urination, more frequent urination,
malodorous urine. Signs of a more serious infection
include the aforementioned symptoms accompanied
by fever, chills, flank pain. Fever and flank pain typically
means that the infection has advanced beyond the bladder
and may be affecting the kidneys. This is a more serious
infection and may require a longer course of antibiotics,
these types of infection are classified as ‘complicated’
urinary tract infections. Without the benefit of a urinary
culture to determine the specific bacteria causing the
infection you are left to treat with an antibiotic that has
good general coverage for most bacterial causes of urinary
tract infections.

Simple Infection - Take ONE tablet by mouth TWICE

per day for 3 days.
Complicated Infection - Take ONE tablet by mouth
TWICE per day for 10 days.

10 Emergency Antibiotic Guide - JASE Medical

DOXYCYCLINE 100 mg
CAUTION - Doxycycline may cause your skin to be more
sensitive to sunlight. Serious sunburns have been reported.
As with any medication, DO NOT TAKE if you are allergic to
doxycycline or other tetracyclines.

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - Using doxycycline in regular doses during

pregnancy is unlikely to produce substantial risk, but data
are insufficient to say that there is no risk. In general, when
there is no better alternative medication, doxycycline is OK
to use during pregnancy. It is classified by the FDA as a
pregnancy risk category B drug (see table in Appendix A).

BREASTFEEDING - Doxycycline is present in breastmilk

however it is in concentrations that are generally
considered safe.

NOTES - Best if taken on an empty stomach, however, if

stomach upset is a concern doxycycline can be taken with
food although absorption will be affected.

Used to treat a variety of infections including, but not

limited to, wounds from human and animal bites,
pneumonia, skin infections, plague, anthrax, tetanus, and
tularemia.

Emergency Antibiotic Guide - JASE Medical 11

Anthrax (bioterror) Exposure
Consult local health officials for event-specific
recommendations.

Inhalation anthrax results from the inhalation of B.

anthracis spore-containing particles. The incubation
period for inhalation anthrax is estimated to be 1 to 7 days.
However, there are reports that show it may be as long
as 43 days. In 2001 there was a bioterror event with 4 to
6 days elapsing from exposure to symptom onset. It is
imperative that treatment be started if there is a chance of
true exposure because within days after symptoms first
appear, if left untreated, inhalational anthrax disease is
nearly 100% fatal.

For post exposure prophylaxis take ONE tablet (or

capsule) by mouth TWICE per day for 60 days.

Pneumonia
Without the aid of a chest x-ray or blood tests you must
rely solely on signs and symptoms to help determine if
pneumonia is present; such as fever, chills, chest pain that
worsens with inspiration and/or expiration, shortness of
breath, and a cough that produces sputum. Amoxicillin-
clavulanate can be taken in conjunction with either
azithromycin or doxycycline to cover most common
causes of pneumonia.

Take ONE capsule by mouth TWICE per day for 5

days with Amoxicillin-Clavulanate 875 mg, take ONE
tablet by mouth TWICE per day for 5 days.

12 Emergency Antibiotic Guide - JASE Medical

Plague (bioterror) Exposure
Consult local health officials for event-specific
recommendations.

For post exposure prophylaxis take ONE capsule by

mouth TWICE per day for at least 14 days and until 2
days have passed without fever.

Skin Infections
(including infections from animal or human bites, as
well as superficial skin infections) - Any kind of wound,
including bite wounds, should be thoroughly cleaned.
Consult your preferred first-aid manual for instructions on
how to properly clean wounds.

Used to prevent infection after an animal or human bite

as well as to treat wounds that may already be infected
after an animal or human bite. Also treats soft tissue and
skin infections including those that may be caused by
methicillin-resistant staph aureus (MRSA). Any break in
the skin can allow bacteria to enter the deeper tissues and
potentially cause an infection. Signs of infection include
worsening pain and redness, pus or drainage, as well as
systemic signs like fever or chills.

Take ONE capsule by mouth TWICE per day for 7

days or until redness is nearly completely gone.
Should not exceed 14 days.

Emergency Antibiotic Guide - JASE Medical 13

Tetanus (Clostridium tetani) Infection
Causes a nervous system disorder characterized by
muscle spasms when infected by the Clostridium tetani
bacterium, which is found in soil. Remember that wound
cleansing is the most important step when any skin
infection is suspected and especially when contamination
with tetanus is a possibility. With limited resources
available it will be hard to know when to treat a wound for
a possible tetanus infection. For this reason, you should
treat an infected wound as a skin infection first by taking
doxycycline. If the infection continues to worsen or you
notice other symptoms like muscle spasms, you can
switch to, or add, metronidazole.
NOTE: Antibiotics to treat a tetanus infection are not very
effective. It is best to make sure that your tetanus booster
is up to date. The Td or Tdap boosters will provide up to
10 years of protection. Metronidazole is preferred over
doxycycline for the treatment of tetanus infection

Take ONE capsule by mouth TWICE per day for

10 days.

14 Emergency Antibiotic Guide - JASE Medical

Tularemia (bioterror)
Consult local health officials for event-specific
recommendations. Tularemia has also been identified
as a possible bioterror agent. Symptoms include a fast
onset of fever, chills, fatigue, headache, lymph node
enlargement, eye pain, light sensitivity, or sore throat or
cough approximately 3-5 days after exposure. In a bioterror
related event the airborne transmission of tularemia is
of highest concern. Ciprofloxacin is an ALTERNATIVE
medication for mild to moderate cases.

Take ONE capsule by mouth TWICE per day for

14 days.

Emergency Antibiotic Guide - JASE Medical 15

FLUCONAZOLE 150 mg
CAUTION - Headache occurs >10%

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - NOT RECOMMENDED; spontaneous

abortion & Fetal malformations can occur with exposure
during the first trimester. Pregnancy Risk Category C (see
table in Appendix A)..

BREASTFEEDING - Enters breastmilk & may cause GI

upset/diarrhea in breastfed infants, otherwise considered
compatible when used in usual recommended doses.

NOTES - May occasionally cause dizziness or seizures.

Use caution driving or operating machinery. May be taken
with meals or on an empty stomach.

Used to treat vaginal candidiasis.

16 Emergency Antibiotic Guide - JASE Medical

Vaginal candidiasis
Also called vulvovaginal candidiasis, candida vulvovaginitis
or vaginal yeast infection, is a colonization of the yeast
Candida in the vagina. Vulvar itchiness is the most
common feature of a vaginal yeast infection. Vulvar
burning, soreness, and irritation are also common
symptoms and can sometimes be accompanied by pain
when urinating or during intercourse. Discharge does not
have to be present but when it is, it is typically white and
thick. However, in some cases it may be thin and watery.

Take ONE tablet by mouth ONCE. May repeat every

eight hours if needed.

Emergency Antibiotic Guide - JASE Medical 17

METRONIDAZOLE 500 mg
CAUTION - May cause headache or stomach discomfort.
Do not use if allergic to metronidazole (Flagyl). DO NOT
TAKE with alcohol. Do not consume alcohol within 3 days
of last dose of metronidazole.

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - Should not be taken during first trimester

of pregnancy unless there are no other options. Pregnancy
Risk Category B (see table in Appendix A)

BREASTFEEDING - Metronidazole is passed into

breastmilk at levels that are considered potentially
dangerous to infant. Loose stools, oral thrush and perianal
fungal infections have been reported in breastfeeding
infants. If metronidazole must be taken, breastfeeding
should be withheld for 12 to 24 hours after a single dose.

NOTES - Take with food to decrease chances of upset

stomach. DO NOT TAKE with alcohol and do not consume
alcohol for 3 days after last metronidazole dose.

Used to treat intra-abdominal infections including those

caused by certain bacteria and parasites such as diarrhea
caused by Giardia and Clostridioides difficile. Treats some
genital-urinary infections such as bacterial vaginosis and
trichomoniasis. Can also be used to treat Tetanus infection
when no other better options are present.

18 Emergency Antibiotic Guide - JASE Medical

Bacterial Vaginosis
The most common cause of abnormal vaginal discharge in
reproductive-age females. Other symptoms include vaginal
odor and sometimes may be accompanied by burning with
urination, itching, and vaginal redness.

Take ONE tablet by mouth TWICE per day for 7 days.

Clostridioides Difficile (C. Diff) (use

when first-line agents such as oral
vancomycin are unavailable)
Watery diarrhea (≥3 loose stools in 24 hours) is the
principal symptom of C. diff and is most often associated
with current or recent use of antibiotics (antibiotic use
within the previous 4 weeks).

Take ONE tablet by mouth THREE times per day for

10 days.

Emergency Antibiotic Guide - JASE Medical 19

Giardiasis
Common in areas with poor sanitation and limited water
treatment facilities. Symptoms of acute infection include
abdominal cramps, bloating, diarrhea, fatigue, fever (rare),
flatulence and nausea. Incubation period from exposure to
symptoms ranges from 1 to 2 weeks.

Take ONE tablet by mouth TWICE per day for 5 days.

Tetanus (Clostridium tetani) Infection

Causes a nervous system disorder characterized by
muscle spasms when infected by the Clostridium tetani
bacterium, which is found in soil. Remember that wound
cleansing is the most important step when any skin
infection is suspected and especially when contamination
with tetanus is a possibility. NOTE: Antibiotics to treat a
tetanus infection are not very effective. It is best to make
sure that your tetanus booster is up to date. The Td or
Tdap boosters will provide up to 10 years of protection.
Metronidazole is preferred over doxycycline for the
treatment of tetanus infection.

Take ONE tablet by mouth FOUR times per day for

10 days.

20 Emergency Antibiotic Guide - JASE Medical

Trichomoniasis
Most common nonviral sexually transmitted disease
worldwide with women more commonly infected than
men. Symptoms of infection are related to those of
bacterial vaginosis although usually with more of an
inflammatory reaction. Burning with urination, pain
with intercourse, itchiness, thin vaginal discharge, and
vaginal odor are all possible symptoms. Most men are
asymptomatic when infected. If symptoms are present,
they normally consist of penile discharge and/ or pain with
urination.

Take ONE tablet by mouth TWICE per day for 7 days.

Emergency Antibiotic Guide - JASE Medical 21

NITROFURANTION 100 mg
CAUTION - DO NOT TAKE if unable to produce urine or if
only producing very small amounts of urine. DO NOT TAKE
if you have significant kidney impairment or Creatinine
Clearance (CrCl) <60mL/min.

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - Use is contraindicated at 38 to 42 weeks of

gestation, during labor and delivery or if onset of delivery
is imminent due to possibility of hemolytic anemia in
the newborn. Pregnancy Risk Category B (see table in
Appendix A).

BREASTFEEDING - Enters breastmilk & contraindicated

in neonates younger than 1 month of age. May cause GI
disturbances in infants.

NOTES - Take with meals to improve absorption and

decrease adverse effects.

Used to treat urinary tract infections (UTIs).

22 Emergency Antibiotic Guide - JASE Medical

Urinary tract infections (UTIs)

Take ONE capsule by mouth TWICE per day for 5

days (females); for 7 days (males)

Emergency Antibiotic Guide - JASE Medical 23

ONDANSETRON 4 mg
CAUTION - Most common side effects reported are
headache and constipation. When taken in combination
with serotonergic agents (such as SSRIs, SNRIs, MAOIs,
citalopram, fluoxetine, etc) a rare but serious complication
may occur. Consult with your physician prior to use.

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - Crosses placenta, use alternative agents

if possible (may be considered when all preferred agents
have failed). Pregnancy Risk Category B (see table in
Appendix A).

BREASTFEEDING - Excretion into breastmilk is unknown.

Potential harm to infant is unknown.

NOTES - Common adverse effects include constipation &

headache.

Used to treat Nausea and vomiting.

24 Emergency Antibiotic Guide - JASE Medical

Nausea\Vomiting

Take ONE tablet by mouth ONCE. May repeat every

eight hours if needed.

Emergency Antibiotic Guide - JASE Medical 25

SULFAMETHOXAZOLE /
TRIMETHOPRIM 800/160 mg
CAUTION - DO NOT TAKE if allergic to any sulfa containing
product. DO NOT TAKE if you have liver damage or severe
kidney diseases. DO NOT TAKE if you have megaloblastic
anemia due to folate deficiency.

EXPIRATION AND STORAGE - see Appendix B

PREGNANCY - This medication crosses the placenta & use

during pregnancy has increased risk of multiple types of
congenital malformations (birth defects). Pregnancy Risk
Category C (see table in Appendix A).

BREASTFEEDING - Enters breastmilk & not recommended

while breast-feeding young infants, especially younger than
2 months of age.

NOTES - Should be taken with 8oz of water. May be taken

with meals or on an empty stomach.

Used to treat bite wounds (animal or human) and urinary

tract infections.

26 Emergency Antibiotic Guide - JASE Medical

Bite wounds

To prevent infection, take ONE tablet by mouth

TWICE per day for 3-5 days.

To treat an existing infection, take ONE tablet by

mouth TWICE per day for 5-14 days.

Urinary tract infections

Take ONE tablet by mouth TWICE per day for 3 days

(females); for 7 days (males).

Emergency Antibiotic Guide - JASE Medical 27

 APPENDIX A
F DA P r e g n a n c y R i s k C a t e g o r i e s

Risk
Definition
Category

Adequate and well-controlled studies have

A failed to demonstrate a risk to the fetus in the
first trimester of pregnancy (and there is no
evidence of risk in later trimesters).
Animal studies have not revealed evidence of
B harm to the fetus but adequate, well-controlled
studies among pregnant women have not
been conducted.
Animal reproduction studies have shown
C an adverse effect on the fetus and there are
no adequate and well-controlled studies in
humans, but potential benefits may warrant
use of the drug in pregnant women despite
potential risks.
There is positive evidence of human fetal
D risk based on adverse reaction data from
investigational or marketing experience or
studies in humans, but potential benefits may
warrant use of the drug in pregnant women
despite potential risks.
Studies in animals or humans have
X demonstrated fetal abnormalities and/or there
is positive evidence of human fetal risk based
on adverse reaction data from investigational
or marketing experience, and the risks involved
in use of the drug in pregnant women clearly
outweigh potential benefits.

28 Emergency Antibiotic Guide - JASE Medical

 APPENDIX B
Expiration Dates and Storage

You’ve invested in an emergency supply of medication and

hopefully will never need to use it. Since these medications
won’t be used immediately, the question becomes how long
do you have before your medications become unsafe?

We recommend that you follow the pharmacy’s label on

your medication when it comes to expiration dates.

In dire circumstances when there is no other option and

the age of your medication is in question it is worth noting
that many medications, both prescription and over-the
counter, are perfectly good to use even after as much as 15
years after their expiration date. Thanks to a government
cost-savings program called Shelf-Life Extension Program
or SLEP, the FDA on behalf of the Department of Defense
studied more than 100 drugs and found that the vast
majority retained their potency for many years beyond
their expiration date. Solid-form antibiotics (tablets and
capsules) were included in the study.
To maximize the potency and shelf-life of your medication it
should be stored in an airtight, cool, dark and dry place.

Emergency Antibiotic Guide - JASE Medical 29

 APPENDIX C
Medication Disposal

When the time comes to dispose of your expired

medications and update your supply there are a couple of
options:

1. Drug Take-Back Program

You local pharmacy or health department may offer a
‘drug take-back program’. This is the preferred way to
dispose of expired, unwanted, or unused medicine.

2. Household Trash
When drug take-back programs aren’t available, federal
guidelines recommend throwing the medicines away in
the household trash after mixing them with a substance
like dirt, kitty litter, or used coffee grounds and then
sealing the mixture in a container like a plastic bag or
other container.

NOTE - Some dangerous medications like narcotics should

be flushed down a toilet or sink. The FDA maintains a list
of dangerous medications that should be flushed when no
drug take-back program is available.

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 APPENDIX D
U S B O X E D WA R N I N G R E G A R D I N G
F LU O R O Q U I N O L O N E S

Fluoroquinolones have been associated with disabling

and potentially irreversible serious adverse reactions
that have occurred together, including: tendinopathy and
tendon rupture, peripheral neuropathy, and CNS effects.
Discontinue ciprofloxacin immediately and avoid the use of
fluoroquinolones in patients who experience any of these
serious adverse reactions. Because fluoroquinolones have
been associated with serious adverse reactions, reserve
ciprofloxacin for use in patients who have no alternative
treatment options.

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 NOTES

32 Emergency Antibiotic Guide - JASE Medical

 NOTES

Emergency Antibiotic Guide - JASE Medical 33

Emergency
Antibiotic
Guide