Introduction
This is my first page so constructive criticism and contribution is welcome. I am writing this page because I see the majority of survivors have an obsession with grabbing antibiotics. No one ever specifies what type of antibiotics and I strongly believe that the majority of survivors have only limited understanding of antibiotics, how they work, the tissues they accumulate in, what bacteria they kill, contraindications and side effects. I will later write a page specifically on the different types of antibiotics and how they work but I'm away from my textbooks and lecture notes so will update it then. I am a qualified microbiologist and I certainly don't know the ins and outs of antibiotics off the top of my head. I would not pick up a firearm at a supply dump because I have no experience with one and it would be a danger to me (Exception: if I had someone in my group with firearm experience who could teach me or there was an instruction manual and I had time to read it then I would). Please treat antibiotics in this way. Use only what you know and only apply it in a way that you know. If you have taken an Amoxycillin + Clavulinate combination for tonsilitis pre-zombie outbreak, then limit your use of amoxycillin+clavulinate to treating tonsilitis, for yourself. Do you have an adrenaline pen with you to treat anaphylactic shock if someone who joins your group is allergic to penicillin and you give this to them? It might have a useful placebo effect if you have a subcutaneous infection but there are cheaper drugs to give people as a placebo. Unless you know how to use the antibiotic you salvage, you are a burden to your team, wasting antibiotics and potentially making the situation worse.

Use of Expired Antibiotics
Drug companies put expiration dates on antibiotics for three potential reasons:

1. The chemical constituents degrade into something toxic

2. The active ingredients degrade so they can only guarantee a particular dose within that time period

3. So you have to buy new antibiotics (excuse my cynicism).

Toxicity
It doesn't have to be a high level of something toxic to cause you problems. Quite possibly a small dose wouldn't hurt a healthy adult (but you're not taking them because you're healthy, are you). Keep in mind that antibiotics are taken as multiple doses over time (so you're poisoning yourself bit by bit and some chemicals build up in your body).

Reduced Dosage
Antibiotics are only useful if they kill off all the bacteria that are causing you a problem (or if they damage them enough for your immune system to eat them). If you don't take enough of a dose and you don't take it frequently enough or for a long enough time you are going to kill off the weaker bacteria, leaving the stronger ones behind. Without the weak ones eating all their food, the strong bacteria that you didn't kill will multiply. You will get sick again. This time, if you try to kill them with the antibiotic, it probably wont work. Now you need a stronger antibiotic. I'm sorry if this is overly simplistic but so many people only take half a course of antibiotics, stopping them when they 'feel better'. This is a problem with expired antibiotics. They may not be as strong as you need them to be and you cannot work out how much they have degraded by looking at the packaging. Weather conditions like temperature and humidity affect the way the antibiotics will degrade. Hot, humid weather is bad for pharmaceuticals.

Drug Companies Making a Profit
Drug companies need to know that their medication will do what they expect within a timeframe. If they don't not only will the FDA not pass them, they might get sued and the publicity will damage their profits more than any payout would. They use statistical modelling and confidence intervals to work out the probability of the drug having the amount of active ingredient it is supposed to after a given period of time. Safety windows will be built in. This means that for most antibiotics you are unlikely to drop dead on the spot if you take a standard dose one month outside the expiry date, when the drug is stored at appropriate conditions. You need to use your own discretion when considering expired medication.



Diseases of Interest in a Zombie Survival Scenario

Diarrhoea
Diarrhoea is a primary cause of death in developing countries. Water purity, contaminated food and poor hygiene are all sources of gastrointestinal disease.

Avoid Sources:

• Treat your water (boil, filter, UV sterilise, chemically disinfect)
• Maintain good personal hygiene. Wash hands after toileting and before handling food/eating. If water is scarce, alcohol wipes (baby wipes, KFC/other fast food outlets wipes, ethanol gel hand sanitisers etc can be used to substitute).
• Temperature abuse is the most common cause of food poisoning. Cook only what you need and cook it thoroughly. Reheating food that has been cooked but not adequately been refrigerated might kill the bacteria but will not deactivate the toxin that causes the food poisoning.
• Contamination is the second most common cause of food poisoning. Do not mix different types of meats and try to keep meats separate from non-meats (vegetables, grains etc).

Treatment:

• Identify the source of disease to stop reinfecting/poisoning the patient and keep others safe.
  
• The majority of people who die from diarrhoea die from dehydration.
• Water is not sufficient because the person looses electrolytes and any food they eat doesn't stay in the body long enough for the nutrients to be absorbed so sugars are also required. Specially designed rehydration powders are best but diluted fruit juices (particularly apple or grape) with a pinch of salt will help. It is important to keep any salts/sugars dilute. If they are too strong they will actually draw the water out of the patient and dehydrate them further.
• Anti-diarrhoeal drugs can be used on adults but may impair your ability to identify the source of disease.

Note also that the above treatment applies for vomiting.

Colds/Flu
Colds and the flu are viral infections. Antibiotics do not kill viruses. It astounds me the number of doctors who are still prepared to prescribe antibiotics for the patient's 'peace of mind' when they present at the surgery with a cold. By all means take advantage of these doctors but do not take the antibiotic for the cold (fill the script a few days before it expires and keep it on hand for when you actually need it because you will have looked up it's mode of action or discussed it with a trusted pharmacist/doctor/vet/medical scientist). Colds/flu are treated by managing fever, maintaining hydration and allowing the patient's immune system to clear the infection.

Sore throat/tonsilitis
90% of sore throats are caused by viruses. The majority of the rest are caused by overpopulation with the patient's own normal flora (the bacteria that are usually good and you need to live in your mouth/throat get a bit enthusiastic and make you sick, it's like kangaroos in the scrub, usually they don't cause a problem unless there are too many of them for the land, then they eat everything and the land is damaged). Adequate oral hygine, gargling with warm salty water will help ease the discomfort and reduce the change of something nasty taking advantage of you being sick to make you worse. Acute tonsilitis can be treated by gargling with warm salty water but if you have a history of more severe tonsilitis you should consider keeping amoxycillin on hand (or whatever you used to treat it previously).

Cuts and abrasions
In a survival situation, any puncture of the skin has the potential to be serious. Pay attention to any cut or scratch. Keep them clean and covered until they seal themselves. If you're going to use superglue remember to get any contaminants out first or you'll only have to bust it open an evacuate them later. Treat scratches from rose thorns as seriously as animal bites. In patients with a good immune system, I would clean the cuts with saline but only treat them with iodine if they became infected. More major cuts should be cleaned with salty water or teatree oil in water (or surgical spirits if you have any spare), loose tissue removed (yes OW but Gangrene would suck!) and kept clean and sealed. Iodine creams (betadine) and chlorhexidine wash are fantastic disinfectants. Pay special attention to animal bites/scratches (including those from humans). Change dressings regularly. This will give you a chance to look for signs of infection (redness, swelling, increased temperature at the site, changes in colouration and the appearance of pus. (side note: a wound is never "*****" it has a "purulent discharge", this eliminates the confusion between pus-like and 'cat'). With a serious wound, watch the patient for an increase in body temperature (fever). Fever may indicate a systemic infection. This is when antibiotics would be very useful.

This is just the start, I'll update when I get a chance, topics to come include Tetanus, Traditional diseases (whooping cough, measles, mumps, polio), Environmental diseases (Legionaires disease, Lyme disease etc). If someone feels enthusiastic covering Gangrene and rabies would be helpful, tks.