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In any situation where modern medicine is not available, there will be a number of deaths that occur from injury and infection. These may occur as a result of contact with hostile neighbors or from epidemic diseases, but many will happen simply from the performance of activities related to survival. Many minor wounds will become contaminated, leading to infections that could easily have been treated with antibiotics.

Years ago, I realized the importance of antibiotics in a family’s medical kit after watching a History Channel program called “After Armageddon”. In it, the Johnson family is caught in a long-term disaster and finds a community that will take them in. The father is a paramedic and has useful medical skills, but simple injuries associated with household chores lead to a soft tissue infection. Without antibiotics, the family is forced to watch their patriarch sicken and die as the infection spreads throughout his body.

In a major disaster, this and many other deaths might be avoided if antibiotics were available. You may be reluctant to treat yourself or family members with these potent drugs. This is understandable: Antibiotics aren’t candy and are best utilized by qualified medical professionals. If there are no trained personnel, however, a layman with a working knowledge of bacterial diseases and their treatments may have no choice but to use antibacterials to save a life.

Note: This is the premise of our book “Alton’s Antibiotics and Infectious Disease: A Layman’s Guide to Available Antibacterials in Austere Settings”.

There are many antibiotics, but which antibiotics accessible to the average person would be good additions to your medical storage? When do you use a particular drug? The wrong antibiotic at the wrong time can be as bad as doing nothing at all. You should have both quantity and variety to be effective as a medic in long-term survival settings.

Today we’ll take the example of a drug that is used in the aquarium industry that is identical to a medication used in humans: Clindamycin, aka “Fish-Cin”. It is also known as “Cleocin”.

Clindamycin is part of the Lincosamide family of drugs. It works by preventing the production of bacterial proteins necessary for growth. This particular medication has been used to treat everything from acne to anthrax.

Clindamycin works best on bacteria that are anaerobic, which means that they don’t require oxygen to multiply. A deep puncture wound like, for example, a cat bite would give rise to favorable environments for anaerobes. Clindamycin is versatile enough to treat or prevent certain bacterial or protozoal causes of:

  • Acne
  • Dental infections
  • Ear Infections
  • Tonsillitis
  • Soft tissue Infections (skin, etc.)
  • Peritonitis (inflammation of the abdomen seen in appendicitis and other medical issues)
  • Some pneumonias and lung abscesses
  • Uterine infections (such as after miscarriage or childbirth)
  • Blood infections
  • Pelvic infections
  • MRSA (Methicillin-resistant Staph. Aureus infections)
  • Parasitic infections (Malaria, Toxoplasmosis)
  • Bone infections
  • Anthrax

 It should be noted that although a certain antibiotic may be effective against a certain infection, that it may not always be the most effective. The drug most in favor at the moment is called the “drug of choice”. The drug of choice may change as new antibiotics are developed or new research becomes available about existing medicines.

In modern medicine, sometimes a physician takes samples from the infection site. These are sent to a laboratory where the offending bacterial species is definitively identified. Obviously, you won’t have such technology available and will have to treat the patient “empirically”; in other words, by using the patient’s signs and symptoms as well as your knowledge to find the right medication.

Clindamycin is not without its side effects, the worst of which might be an inflammation of the colon, known as “colitis”. In rare cases, this condition may be severe enough to be life-threatening. Avoid using in people with known intestinal diseases and discontinue if bowels become irregular.

The drug may also irritate the tube that runs from the mouth to the stomach, also called the “esophagus”. As such, take clindamycin capsules with a full glass of water.

Proper storage will increase the shelf life of a medication, often beyond its expiration date. Clindamycin in solid form should be kept at in dry, dark, cool (no higher than room temperature) conditions. Liquid clindamycin suspensions becomes “sludgy” in the refrigerator and should be discarded after two weeks.

The dosage of clindamycin is 150mg or 300mg (Fish-Cin comes in 150 mg) and for most infections is taken every 6 hours with a glass of water. Pediatric dosing varies with the weight of the child:

Body weight 10 kg or less:

Minimum recommended dose: 37.5 mg orally three times a day

Body weight 11 kg or more:
Serious infection: 8 to 12 mg/kg orally per day, in 3 to 4 equally divided doses
Severe infection: 13 to 16 mg/kg orally per day, in 3 to 4 equally divided doses
More severe infection: 17 to 25 mg/kg orally per day, in 3 to 4 equally divided doses

(For a detailed list of dosing for each infection, see “Alton’s Antibiotics and Infectious Disease”)

This drug is pregnancy category B, which means that no ill effects have been determined in animal studies. Drug testing is rarely done on pregnant humans, so very few pharmaceutical companies are willing to guarantee safety during pregnancy.

Clindamycin is acceptable for use in patients with Penicillin allergies. This is not to say that you might not have an allergy to Clindamycin itself, however.

Knowing how to identify infections and which antibiotics to use is important for any off-grid medic. Have a supply of antibiotics in your storage, but use them only when absolutely necessary.

Joe Alton, MD

Dr. Alton

Learn more about antibiotics and bacterial diseases in Alton’s Antibiotics and Infectious Disease, available on Amazon or at!

Hey, don’t forget to check out our entire line of quality medical kits and individual supplies at Also, our Book Excellence Award-winning 700-page SURVIVAL MEDICINE HANDBOOK: THE ESSENTIAL GUIDE FOR WHEN HELP IS NOT ON THE WAY is now available in black and white on Amazon and in color and color spiral-bound versions at

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