Antibiotics

Humblefish

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Antibiotic treatment

What It Treats
Bacterial infections, which are oftentimes “secondary” to preexisting parasitic (and worm) infestations.

How To TreatFollow the directions on the label of whatever product you are using. Always use a broad spectrum antibiotic medication i.e. one that treats both gram-positive and gram-negative bacterial diseases.

The following are medications I recommend (in order of preference):

1) Ciprofloxacin (Best administered via a 1-hour bath treatment. Dosage is high: 250mg per gal. Repeat every 24 hours for 7 days.)

2) Enrofloxacin (Most advanced antibiotic approved for use in tropical fish ... Dosage range is 2.5 - 5 mg/L daily for 7 days; can be used both in a QT or as a 5 hour bath treatment. The tricky thing about Enrofloxacin is the 2.5 - 5 mg/L dosage range is actually safe for QT use, but the nitrifying bacteria will also take a hit. So, the primary reason to administer the medication as a 5 hr bath is to spare your biofilter.)

3) Nitrofuracin Green Powder (Best used in a QT with no working biofilter, as the Methylene Blue contained therein can destroy nitrifying bacteria.)

4) AAP Spectrogram (Kanamycin/Nitrofurazone synergistic combination … Can be combined with Metronidazole … Can be safely used in a QT with a working biofilter.)

5) Furan-2 + Seachem Kanaplex + Metroplex (metronidazole) – Can be used separately, but most effective when all 3 are combined together. Furan-2 + Kanaplex should be dosed at the same time for maximum effectiveness. Can be used in a QT with a working biofilter.

6) Triple Sulfa Powder

7) Seachem Sulfaplex + Neoplex
(Can be used separately or together.)

8) Maracyn 1 (Erythromycin) – Best antibiotic for treating eye infections.

When using antibiotics, it is very important to treat for 7 - 10 consecutive days. Follow the instructions on the label – which may say to dose every 24 or 48 hours, do water changes, etc. But use the product for 7 - 10 continuous days (as directed). Sometimes a fish will look & act better after just a few days of treatment; however the infection can return if you end treatment prematurely. Or sometimes the opposite will happen, as antibiotics can be notoriously slow acting with fish. If a fish shows no signs of improvement after 10 days, then it’s time to try a completely different medication. Just like with humans, sometimes a certain fish will respond better to a different treatment.

The medications listed above are primarily meant to be dosed into the water. Using antibiotics in a QT environment (or bath treatment) fits within the comfort level of most hobbyists. However, the best way to apply antibiotics is via intramuscular injection (obviously difficult to do with small fish). The first step is to sedate the fish using MS-222 (Tricaine Methanesulfonate). Next, inject an antibiotic (e.g. enrofloxacin), or a steroid such as dexamethasone to help reduce inflammation/swelling. The injection is made into the muscle on the side of the dorsal ridge, angling the needle towards the head or tail to avoid hitting any major organs below. Typically you would use a tuberculin syringe with a 27 gauge needle to draw up the solution and a 30 gauge needle to inject. After the injection is complete, place the fish in a heavily oxygenated bucket with clean saltwater and glide the fish through the water until he is revived. Dosage for Intramuscular dexamethasone varies from 1-2 mg/kg. Dosing info for enrofloxacin and other fish antibiotics can be found here.

You can also food soak antibiotics; this is especially useful for treating internal infections. Neomycin (e.g. Neoplex) will not get absorbed by the fish’s gastrointestinal tract, thus making it an excellent antibiotic to soak in food. I’ve also had success using kanamycin (e.g. Kanaplex) to treat internal infections. Metronidazole (e.g. Metroplex) is another good option and can also be used to treat internal flagellates. See Table 1 (here) for other ABX which can be soaked in food. It is also important to use a binder to greatly reduce the loss of medication to the water through diffusion (this also makes food soaking reef safe). Seachem Focus, unflavored gelatin or agar are all examples of binding agents that can be used. My recipe for food soaking ABX can be found below:

Using a shot glass:
1 scoop (~ 1/8 teaspoon) of medication
1 scoop Focus
1 tbsp food (preferably pellets or frozen food)
A few drops of saltwater or fish vitamins
Stir until a medicated food slurry has been achieved
Feed after soaking for 30 mins

Refrigerate or freeze any leftovers for future use

ProsCan be mixed with other medications; however effectiveness may be limited if used in the presence of an immunosuppressant (e.g. copper, Chloroquine).

Cons/Side EffectsSuppresses appetite, depletes the water of oxygen (so provide additional gas exchange). Antibiotics dosed in water are notoriously slow acting in fish.

Further reading below:

Use of Antibiotics in Ornamental Fish Aquaculture

http://www.americanaquariumproducts.com/AquariumMedication2.html
 
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mcarroll

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Please read this University of Fla. doc too before applying any antibiotics:
Use of Antibiotics in Ornamental Fish Aquaculture

It's targeted at aquaculture (fish farmers) and zoos, etc.....so don't get flustered by some of the terminology. Humblefish is our acting "fish health specialist" to use that doc's lingo. :)

It makes a good compliment to the materials here.

Our Con's list could probably be expanded quite a bit....but antibiotics is a complex topic and that may be beyond the scope of this post. So check out the link!

Briefly, a couple quotes:
"Antibiotics, in and of themselves, do not cure a fish. Antibiotics merely control the population growth of bacteria in a fish long enough for its immune system to eliminate them."

"Before antibiotics are even considered, sources of stress such as poor water quality (including drastic temperature change), nutrition, genetics, and handling or transport must be removed or reduced."​

It also includes a summary of the most common antibiotics and a table showing dosage rates.
 
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Humblefish

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Added in this part about treating internal infections and food soaking:
For internal infections, it is best to soak the fish food in an antibiotic such as Kanaplex. However, you'll need to use a binder, such as Seachem Focus, to prevent the medication from leaching out into the water. (The ratio is 1 scoop of Kanaplex + 1 scoop of Focus per 1 tablespoon of pellets or frozen food.) This approach will sometimes work on external infections, but for those it is better to treat the water in a quarantine tank as outlined above.

It's also not a bad idea to run carbon while food soaking any medication, just in case a little does leach out. ;)
 

prsnlty

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Since I can't remove my fish from my tank without tearing the tank down, at the first sign no matter how minor it is that there's something wrong this is what I feed my fish. It has worked very well for me so far.
e4f4d7d2e42d337f5f26ca3881aac90e.jpg
 

Eggpaul

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If adding the trio (or 1 of the trio) to a QT tank with live rock, what happens to that live rock? Can it be placed back into the sump sometime later? @Humblefish
 
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Humblefish

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Humblefish

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Okay. So I should remove the live rock (1 large piece) before adding the medicine? I do have a filter pad in there also that used to be in the sump. Just thought I'd need the rock also for more filtration.

Yes, you want to use antibiotics in as sterile an environment as possible.
 

mcarroll

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Ideally treat when necessary in a hospital tank and them move them back to the QT with the live rock afterward.

Don't use the QT as the treatment tank if you can help it....it just complicates an already complicated situation.
 

Eggpaul

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Ideally treat when necessary in a hospital tank and them move them back to the QT with the live rock afterward.

Don't use the QT as the treatment tank if you can help it....it just complicates an already complicated situation.

So I need to have a hospital tank also? I thought that's what the QT is for. Can I just remove the rock when medication is needed? Maybe add another filter pad instead?
 

Bob Escher

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Antibiotics: Treats bacterial infections, which are oftentimes “secondary” to preexisting parasitic (and worm) infestations.

How To TreatFollow the directions on the label of whatever product you are using. Always use a broad spectrum antibiotic medication i.e. one that treats both gram-positive and gram-negative bacterial diseases.

The following are medications I have experience using which contain wide spectrum antibiotic(s):
  • Nitrofuracin Green Powder
  • Seachem Kanaplex
  • Furan-2
  • Triple Sulfa Powder
  • Maracyn 1 (erythromycin) + Maracyn 2 (minocycline) used in combination together
When battling a severe bacterial infection, combining Furan-2 + Kanaplex + metronidazole (ex. Seachem MetroPlex) can be both effective and safe.

The following are medications I have no experience using but these still contain wide spectrum antibiotic(s):
  • Seachem Neoplex
  • Seachem Sulfaplex
  • Maracyn Plus
When using antibiotics, it is very important to treat for 10 consecutive days. Follow the instructions on the label - which may say to dose every 24 or 48 hours, do water changes, etc. But use the product for 10 continuous days (as directed). Sometimes a fish will look & act better after just a few days of treatment; however the infection can return if you end treatment prematurely. Or sometimes the opposite will happen, as antibiotics can be notoriously slow acting with fish. If a fish shows no signs of improvement after 10 days, then it’s time to try a completely different medication. Just like with humans, sometimes a certain fish will respond better to a different antibiotic. Or you have to find the proper antibiotic which will successfully target the offending bacteria. The latter is best accomplished by taking a skin scrape of the affected area(s) and identifying the harmful bacteria/infection on the fish's skin by using a microscope.

For internal infections, it is best to soak the fish food in an antibiotic such as Kanaplex. However, you'll need to use a binder, such as Seachem Focus, to prevent the medication from leaching out into the water. (The ratio is 1 scoop of Kanaplex + 1 scoop of Focus per 1 tablespoon of pellets or frozen food.) This approach will sometimes work on external infections, but for those it is better to treat the water in a quarantine tank as outlined above.

ProsCan be mixed with other medications; however still watch out for a bacterial bloom (cloudy water), especially when combining with Prazipro.

Cons/Side EffectsSuppresses appetite, depletes the water of oxygen (so provide additional gas exchange).
Well here’s a pic of him in QT
This fast he was fine last night
Hm I only have furn to treat him with with

4E52A00C-24F4-476D-AB85-7A2BEB26BC47.jpeg


827598C5-037E-47D1-97EF-956265236F70.jpeg


C1564B75-17A1-4859-8F53-22D29F00919E.jpeg
 

4FordFamily

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So I need to have a hospital tank also? I thought that's what the QT is for. Can I just remove the rock when medication is needed? Maybe add another filter pad instead?
I always treat in quarantine and use the two interchangeably — this because I treat everything prophylactically to protect my fish in my DTs.
 

pecan2phat

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So when you say treat for 10 consecutive days, follow the instructions on the label, I'm a bit confused.
Furan-2 is a 4 dose protocol with a 25% water change in-between and another 25% water change on the 5th day.
Are you suggesting that it should be full course dosed again for 2 treatments?
 

HotRocks

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This Sticky (Original Post) has been edited with new info. Reflecting up to date procedures and currently available products etc.
 

Ardeus

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Antibiotic treatment


What It TreatsBacterial infections, which are oftentimes “secondary” to preexisting parasitic (and worm) infestations.

How To TreatFollow the directions on the label of whatever product you are using. Always use a broad spectrum antibiotic medication i.e. one that treats both gram-positive and gram-negative bacterial diseases.

The following are medications I recommend (in order of preference):

1) Nitrofuracin Green Powder (Best used in a QT with no working biofilter, as the Methylene Blue contained therein can destroy nitrifying bacteria.)

2) AAP Spectrogram (Kanamycin/Nitrofurazone synergistic combination … Can be combined with Metronidazole … Can be used in a QT with a working biofilter.)

3) Furan-2 + Seachem Kanaplex + Metroplex (metronidazole) – Can be used separately, but most effective when all 3 are combined together. Furan-2 + Kanaplex should be dosed at the same time for maximum effectiveness. Can be used in a QT with a working biofilter.

4) Triple Sulfa Powder

5) Seachem Sulfaplex + Neoplex (Can be used separately or together.)

6) Maracyn 1 (Erythromycin) – Best antibiotic for treating eye infections.

When using antibiotics, it is very important to treat for at least 10 consecutive days. Follow the instructions on the label – which may say to dose every 24 or 48 hours, do water changes, etc. But use the product for 10 continuous days (as directed). Sometimes a fish will look & act better after just a few days of treatment; however the infection can return if you end treatment prematurely. Or sometimes the opposite will happen, as antibiotics can be notoriously slow acting with fish. If a fish shows no signs of improvement after 10 days, then it’s time to try a completely different medication. Just like with humans, sometimes a certain fish will respond better to a different treatment.

The medications listed above are primarily meant to be dosed into the water. Using antibiotics in a QT environment (or bath treatment) fits within the comfort level of most hobbyists. However, the best way to apply antibiotics is via intramuscular injection (obviously difficult to do with small fish). The first step is to sedate the fish using MS-222 (Tricaine Methanesulfonate). Next, inject an antibiotic (e.g. enrofloxacin), or a steroid such as dexamethasone to help reduce inflammation/swelling. The injection is made into the muscle on the side of the dorsal ridge, angling the needle towards the head or tail to avoid hitting any major organs below. Typically you would use a tuberculin syringe with a 27 gauge needle to draw up the solution and a 30 gauge needle to inject. After the injection is complete, place the fish in a heavily oxygenated bucket with clean saltwater and glide the fish through the water until he is revived. Dosage for Intramuscular dexamethasone varies from 1-2 mg/kg. Dosing info for enrofloxacin and other fish antibiotics can be found here.

You can also food soak antibiotics; this is especially useful for treating internal infections. Neomycin (e.g. Neoplex) will not get absorbed by the fish’s gastrointestinal tract, thus making it an excellent antibiotic to soak in food. I’ve also had success using kanamycin (e.g. Kanaplex) to treat internal infections. Metronidazole (e.g. Metroplex) is another good option and can also be used to treat internal flagellates. See Table 1 (here) for other ABX which can be soaked in food. It is also important to use a binder to greatly reduce the loss of medication to the water through diffusion (this also makes food soaking reef safe). Seachem Focus, unflavored gelatin or agar are all examples of binding agents that can be used. My formula for food soaking ABX can be found below:

Using a shot glass:
1 scoop (~ 1/8 teaspoon) of medication
1 scoop Focus
1 tbsp food (preferably pellets or frozen food)
A few drops of saltwater or fish vitamins
Stir until a medicated food slurry has been achieved
Feed after soaking for 30 mins
Refrigerate (For 5-7 Days) or freeze any leftovers for future use


ProsCan be mixed with other medications; however effectiveness may be limited if used in the presence of an immunosuppressant (e.g. copper, Chloroquine).

Cons/Side EffectsSuppresses appetite, depletes the water of oxygen (so provide additional gas exchange). Antibiotics dosed in water are notoriously slow acting in fish.

Further reading below:

Use of Antibiotics in Ornamental Fish Aquaculture

http://www.americanaquariumproducts.com/AquariumMedication2.html

In Europe it's not possible to find seachem focus. Can you tell me how to use gellatin to bind the antibiotics to frozen mysis for example?
 
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Humblefish

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The original post of this thread has been updated with new information.

Including the use of Ciprofloxacin and Enrofloxacin, the most advanced antibiotics approved for use in tropical fish.
 

sksouthpaw

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So I have a question, stumbled on this page when researching antibiotics in fish. Im not a fish doctor so I may be wrong but I feel the general treatment principle of any bacterial infection whether gram positive or negative would be the same in human’s as with fish.
my question is in regards to the IM dosing.

In one section you suggest administering IM Enrofloxacin OR IM dexamethasone. To me that would be a no no. Im assuming you mean to admin. Dexamethasone IM in conjunction with either IM Enrofloxacin or PO/water column abx.
From my experience and training (atleast in humans) treating a bacterial infection, especially being moderate to severe (why else would we be doing IM instead of topical or PO) with Dexamethasone monotherapy would be a recipe for disaster.
It will acutely maybe take down some of the inflammation and erythema, however the bacterial infection (the root cause, not the SYMPTOM) would drastically worsen and likely kill the host if not treated concurrently with an antibiotic.
that would be the equivalent of me treating, in the clinic, a community aquired/bacterial pneumonia with an IM of methylprednisolone and then an outpatient PO medrol dose pack.
The patient may feel better symptomatically at first but when they inevitably end up in the ICU with sepsis and septic emboli with acute renal failure/multi system organ failure on a vent, stemming from a pneumonia treated with a steroid, I would promptly be served a lawsuit by some very upset family members and likely have my license suspended by the board.
HOWEVER take the same patient, give a 60mg IM dose of methylprednisolone & Ceftriaxone 1g IM or IV along with an outpatient medrol dose pack and zpack, and they will be just fine.
So take into account that if we are treating with IM we either have a moderate to severe infection or an infection with drug resistance where PO therapy is not indicated, or significant allergies. However, being in a fish (i dont know this for sure) we probably arent doing it for multiple allergies/intolerance, we are really likely to do this in case of severe infection or with multiple oral/topical treatment failure. Because of this, we again, certainly would not want to use a steroid as MONOTHERAPY.
Just my 2 cents, but all of the rest was very informative!
 
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