Malarone should be taken 2 days before being exposed to areas that are at risk for Malaria, regardless of whether you plan on going into the back country, as the mosquitos can fly all over the area. Since you may be traveling back and forth between areas at risk and since the Malarone is needed for 7 days after exposure, it may be necessary to continue on this medication for the duration of your trip. It depends on when the last time you will be in an area at risk. Although the use of Larium is more convenient being dosed weekly it has more side effects and I would recommend Malarone daily instead.
Traveler’s Diarrhea (Cipro 500 mg (or Bactrim DS) twice a day for 7 days)
This is caused from contaminated water and/or food. Although 98% of the time this illness goes away without any antibiotics being used it would be prudent to have some on your trip. There are serious side effects in using antibiotics indiscriminately so I would consult a physician on your trip before starting this if possible. Antibiotics are warranted to treat diarrhea in those who develop moderate to severe diarrhea as characterized by more than four unformed stools daily, fever, blood, pus, or mucus in the stool. A full course would be Cipro 500 mg every 12 hours for 7 days so 14 pills would be needed. If you start the Cipro I recommend taking a Probiotic (Probio by Pharmanex, one pill twice a day) in order to minimize the side effects of diarrhea and yeast infections that may result from the Cipro. A probiotic puts back the good bacteria that the Cipro (or other antibiotics) kills. The use of an anti-diarrheal should be minimized as the body’s defense mechanism for food poisoning is to shed bacteria in the stool and if the diarrhea is stopped the infection can be prolonged. If the diarrhea is resulting in dehydration then judgment needs to be used as to what to do. Consult a physician on the trip if possible.
Skin Infections (Keflex 500 mg three times daily or Bactrim DS two times daily for 7-10 days, use until at least 2 days after the infection appears to be totally resolved)
Skin infections occur within 2 days of getting cut. The best treatment is washing the wound with soap and water vigorously. If the wound is a dirty one then 3 days of antibiotics may be used for prevention of an infection. Should a wound appear to be infected (increased warmth, redness and tenderness) then at least a 7 day course should be taken. Any infection associated with a fever over 101 or red streaking going towards the center of the body warrants medical attention.
Bring along Steri-Strips which is medical tape to hold cuts together. Before applying this, clean and dry the wound thoroughly. Applying Benzoin or another medicinal liquid for the strips to stick to is recommended. Do not get the Benzoin in the wound. It is only to provide a sticky area for the Steri-strips to stick securely. As the strips start peeling back simply trim them with scissors. After 10 days the strips can be removed entirely. Reapply fresh ones to help prevent the wound from reopening after cleaning the area.
Most respiratory infections are due to viral illnesses and do not respond to antibiotics. If the following symptoms occur then the likelihood of a bacterial infection increases and a course of antibiotics might be warranted. These symptoms consist of a persistently colored productive cough (green, yellow or blood tinged) and a fever >101. Symptoms that occur upon awakening and then resolve as the day goes on is not likely due to a bacterial infection and therefore do not respond to antibiotics. Symptoms consisting of generalized body aches and fatigue with a nonproductive cough without a fever is usually viral. Anytime this occurs with a significant headache and a stiff neck it needs to be evaluated promptly to confirm that meningitis is not present.