Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Antibiotics for a Trip to Nepal

As I mentioned in some of my first few posts, I had the good fortune to travel to Everest Base Camp in Nepal. In response to those posts and in the past, I was asked to comment on what antibiotics should be carried in a first aid kit.

First, what I am about to say is not a prescription for specific medical advice for a condition. It is, rather, a suggested list of drugs that might be carried to deal with infections that are often encountered during a trek in Nepal.

For a complete list of what to carry in a first-aid kit, see the section on First-Aid kits in the book Medicine for the Outdoors. With respect to antibiotics, you will need to get prescriptions for these from a physician or other health care provider licensed to write prescriptions. Be certain to explain any known allergies or bad reactions you have had to drugs in the past, and have the use of all medications explained to you prior to your travel, including side effects and interactions with other drugs or substances (such as metronidazole with alcohol).

The antibiotics I would recommend are:

1. Ciprofloxacin for infectious (bacterial) diarrhea. Given the incidence of certain bacteria that are resistant to ciprofloxacin, it is also wise now to also carry azithromycin (see #3).
2. Ampicillin or amoxicillin-clavulanate or something similar for sinus infection, skin infection, or ear infection.
3. Azithromycin for bronchitis, pneumonia, or serious throat infection.
4. Trimethoprim-sulfamethoxazole or doxycycline for methicillin-resistant Staphylococcus aureus (MRSA) infection.
5. Metronidazole or something else effective against Giardia lamblia and for dental infections.

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photo by Terry Johnson
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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.