As a medical doctor and after 18 years of travel around the world, I feel qualified to give good advice about travel health.
The drugs I routinely carry are ibuprofen, (or Vitamin I for those of us getting on in age), a combined cream, Cipro, Azithromycin and Coartem if going to a malarial zone. Buy the antibiotics in 3rd world countries as you don’t need to see a Dr and get a prescription. Even as a retired physician, I have to go through the same laborious process to get prescriptions in 1st world countries (usually very expensive and time-consuming).
1. Ibuprofen. An effective analgesic/anti-inflammatory that is generally well tolerated. (I use much larger doses than most people often in the 800-1200mg range). Great for headaches, joint inflammation, menstrual cramps.
2. Dimenhydrinate (Gravol). A reasonable antiemetic. Available as tablets or suppositories if unable to hold anything down. Great for car and sea sickness.
3. Combined cortisone/antifungal/antibacterial cream. Useful for a. any skin inflammation (chapped skin). b. Angular chelitis (occurs at corners of lips when lose vertical space causing a chronic infection usually involving yeast and Staphylococcus). There are many products.
4. Decongestants. For those inevitable colds, use pseudoephedrine and nasal sprays like Otrivin.
5. Antibiotics. Available only by prescription from a doctor in North America and Europe, one can often obtain these with no prescription elsewhere in the world. Stock up on these when in countries where prescriptions are not necessary.
Travelers Diarrhea: Here advice from local physicians who know the common responsible organisms can be worthwhile. a. Activated Charcoal Tablets, 250 mg – These work wonders for traveller’s diarrhea! Instead of just keeping you from pooping (which is what Imodium does) the charcoal absorbs the bacteria in your body so you can get rid of it on your next bowel movement. b. Ciprofloxacin (500mg od or bid for 3 days) taken early in the episode can be effective for E coli, the most common cause. c. Azithromycin as resistance to Cipro is becoming more common d. Metronidazole (for giardia or amoebic dysentery).
Bronchitis and pneumonia 1. Amoxil (500mg tid x 7 days) – old fashioned but can be effective alone if you have a productive cough. 2. Azithromycin (Zithromax 1/day. The best outpatient treatment for pneumonia 3. Levofloxacin
6. Malaria. I don’t use prophylactics for many reasons (see Malaria discussion) but instead carry two courses of the active and best treatment, Coartem. Available anywhere in Africa for about $10. Dose 1 twice/day for three days at first sign of fever and feeling like a bad hangover. Ideally, one would like a blood smear to confirm the diagnosis, but is one is not available, simply take the drug. It is very safe and well tolerated and all that is lost is $10. It is essential to treat malaria as early as possible.
