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I feel like I read all too often of people on here jumping to dump antibiotics into their tank. In a lot of cases, they don't even realize what antibiotics are or how they work. I would like to explain, in depth, why I (as a biology student) am so quick to tell people not to use antibiotics, at least not as their first medication option.
First off, what are antibiotics?
Antibiotics are a class of medications that kill bacteria, and in certain medications, other microorganisms. They work through various mechanisms, often by preventing synthesis of cell walls, proteins, DNA, RNA, or other key biological molecules or structures.
What is antibiotic resistance?
Bacteria are rapidly evolving organisms. A single generation, on average, only lasts about 20 minutes! Because of their innate machinery, bacteria can find ways to deal with new problems very quickly. That includes antibiotics. If we kill off most of the bacteria that are susceptible to a specific antibiotic, there is a chance that a tiny minority of those bacteria have evolved a way to avoid susceptibility to that antibiotic. For example, bacteria can evolve to create a new membrane pump that pushes the antibiotic out of the cell faster than it leaches in. Alright, so now we've killed off a few million bacteria, and left a few survivors that aren't susceptible to the antibiotic anymore. The ones that survived may have the opportunity to proliferate. Give it some time, and now you've got a few million bacteria again, except this time, a higher percentage of them are resistant to the antibiotic than before.
The more we use antibiotics, the more this cycle compounds, and the more bacteria are resistant to antibiotics. In fish terms: we are selectively breeding bacteria by culling them with antibiotics. Every time we use an antibiotic, we are culling the "weak" bacteria, and allowing the "strong" bacteria to survive and breed the new generations of bacteria that are stronger and harder to kill with antibiotics. You don't want this! Why? Because the next time you use that antibiotic, it's less likely to work. This can accumulate and become such a problem (throughout the entire hobby and human medicine, not just your own tank!) that a particular antibiotic can become completely useless and ineffective!
"So, what?"
I believe it is worth mentioning that although up to this point I have only been discussing antibiotics as they relate to aquariums, the topic of antibiotic resistance is extremely relevant to humans as well. All the antibiotics that we use to treat our aquariums were first used to treat humans, and still are. The problem of antibiotic resistance isn't isolated on the level of our home aquariums. It is true that you can spread antibiotic resistance among the aquarium hobby by trading fish, plants, filter media, and plenty of other equipment, and it is also true that you can spread antibiotic resistance from aquariums to people. Even if the bacteria themselves are not harmful to people, bacteria can pass on plasmids (tiny pieces of free-floating DNA) to other bacteria, even if they are not related strains of bacteria. These plasmids often code for antibiotic resistance. Antibiotic resistance can be spread from aquariums and fish to people and other animals very easily, and contributes to the rapidly growing antibiotic resistance problems encountered in human medicine. If you don't believe me, the link below expands upon this issue.
Fancy Fish - Antibiotic Resistance
And as a side note, another reason why it matters - antibiotics can kill your cycle. What lives in your filter, fueling your cycle and keeping your fish healthy and alive? Bacteria! It should come as no surprise that certain antibiotics absolutely can, and will, kill the bacteria responsible for your cycle. Keep that in mind the next time you're about to throw some antibiotics in your tank, and set up a hospital tank if you absolutely need to dose them!
What medications are antibiotics?
Like a lot of products in the aquarium hobby, antibiotics aren't always properly labeled. Those "fish meds" you have might actually be antibiotics in disguise. Here's a list of common aquarium antibiotics, providing both the brand name and formal name when possible:
- Maracyn/Erythromycin
- Azithromycin
- Furan/Nitrofurazone
- Kanaplex/Kanamycin
- Sulfaplex/Sulfathiazole
- Neoplex/Neomycin
- Tetracycline
- Metronidazole*
*Although Metronidazole is an antibiotic, it is mostly used as an antiprotozoal rather than an antibacterial, and is more acceptable for general use than the others. One of the active ingredients in General Cure.
When are they inappropriate to use?
Here's a quick rundown of when antibiotics should not be used:
- When you're unsure why your fish is sick. There are many types of infections: bacterial, fungal, parasitic... Just because your fish is sick does not mean it's a bacterial infection. There is a high likelihood your sick fish is not going to benefit from antibiotics anyway if you're not sure it's bacterial.
- When you haven't tried non-medication fixes first. A lot of sick fish are sick because of water quality, improper parameters, or stress, not because of an infection. An issue may come down to a soft water fish being in water that's too hard, or tropical fish looking drab and lethargic in cold water, or incompatible stocking, rather than a disease or infection. The infection will keep re-occurring if you never fix the root of the problem.
- When you haven't tried non-antibiotic treatments first. Keep antibiotics as a last resort. For example, clean water +- aquarium salt can (in most cases) clear up fin rot, one of the most common bacterial infections, without antibiotics. Epsom salt baths can clear up swim bladder disorder without antibiotics.
- When you want to dose preventatively when your fish aren't sick. I agree with preventative treatment! However, I absolutely, 100%, with every ounce of my being, do not believe in dosing antibiotics as a preventative. All you're doing is setting up your tank and your fish to be resistant when there might be a time down the road you do need to use antibiotics! Don't do it, I beg you! Quarantine your fish! Treat preventatively for parasites, if you must. Not for bacterial infections.
When are they appropriate to use?
- When you've ruled out easy fix issues like water quality. As we have all encountered at one point or another, beginners - through no fault of their own - may not be familiar with the nitrogen cycle, and are more likely to have water quality issues that cause illness. These beginners are also more likely to jump to grab antibiotics off the shelf and use them without second thought. Rule out these easy fix issues before checking off this box.
- When you are confident that your fish are sick because of a bacterial infection. When in doubt, ask! There are some fantastic aquarists on this forum who are always more than willing to help you diagnose and form a treatment plan for your fish.
- When you've exhausted all other treatments, and your fish still aren't healthy. The exception to this rule is when you're dealing with something that has a clear bacterial diagnosis, like Columnaris, and you are certain that (for example) an anti-parasite treatment is not worth trying first.
All of the above should be checked off before you proceed with antibiotic treatment.
"Do you just hate antibiotics?"
No! I believe antibiotics are some of the best medicines that humans have had the ingenuity to discover and create. They have saved countless numbers of people from certain death. That is why we need to use them mindfully and in moderation so that we will still be able to use them when they are medically necessary, and continue to save lives!
Thank you for reading! I hope you learned something new, and spread your new knowledge to those who seek your advice. Have a good day! Please feel free to ask questions!
First off, what are antibiotics?
Antibiotics are a class of medications that kill bacteria, and in certain medications, other microorganisms. They work through various mechanisms, often by preventing synthesis of cell walls, proteins, DNA, RNA, or other key biological molecules or structures.
What is antibiotic resistance?
Bacteria are rapidly evolving organisms. A single generation, on average, only lasts about 20 minutes! Because of their innate machinery, bacteria can find ways to deal with new problems very quickly. That includes antibiotics. If we kill off most of the bacteria that are susceptible to a specific antibiotic, there is a chance that a tiny minority of those bacteria have evolved a way to avoid susceptibility to that antibiotic. For example, bacteria can evolve to create a new membrane pump that pushes the antibiotic out of the cell faster than it leaches in. Alright, so now we've killed off a few million bacteria, and left a few survivors that aren't susceptible to the antibiotic anymore. The ones that survived may have the opportunity to proliferate. Give it some time, and now you've got a few million bacteria again, except this time, a higher percentage of them are resistant to the antibiotic than before.
The more we use antibiotics, the more this cycle compounds, and the more bacteria are resistant to antibiotics. In fish terms: we are selectively breeding bacteria by culling them with antibiotics. Every time we use an antibiotic, we are culling the "weak" bacteria, and allowing the "strong" bacteria to survive and breed the new generations of bacteria that are stronger and harder to kill with antibiotics. You don't want this! Why? Because the next time you use that antibiotic, it's less likely to work. This can accumulate and become such a problem (throughout the entire hobby and human medicine, not just your own tank!) that a particular antibiotic can become completely useless and ineffective!
"So, what?"
I believe it is worth mentioning that although up to this point I have only been discussing antibiotics as they relate to aquariums, the topic of antibiotic resistance is extremely relevant to humans as well. All the antibiotics that we use to treat our aquariums were first used to treat humans, and still are. The problem of antibiotic resistance isn't isolated on the level of our home aquariums. It is true that you can spread antibiotic resistance among the aquarium hobby by trading fish, plants, filter media, and plenty of other equipment, and it is also true that you can spread antibiotic resistance from aquariums to people. Even if the bacteria themselves are not harmful to people, bacteria can pass on plasmids (tiny pieces of free-floating DNA) to other bacteria, even if they are not related strains of bacteria. These plasmids often code for antibiotic resistance. Antibiotic resistance can be spread from aquariums and fish to people and other animals very easily, and contributes to the rapidly growing antibiotic resistance problems encountered in human medicine. If you don't believe me, the link below expands upon this issue.
Fancy Fish - Antibiotic Resistance
And as a side note, another reason why it matters - antibiotics can kill your cycle. What lives in your filter, fueling your cycle and keeping your fish healthy and alive? Bacteria! It should come as no surprise that certain antibiotics absolutely can, and will, kill the bacteria responsible for your cycle. Keep that in mind the next time you're about to throw some antibiotics in your tank, and set up a hospital tank if you absolutely need to dose them!
What medications are antibiotics?
Like a lot of products in the aquarium hobby, antibiotics aren't always properly labeled. Those "fish meds" you have might actually be antibiotics in disguise. Here's a list of common aquarium antibiotics, providing both the brand name and formal name when possible:
- Maracyn/Erythromycin
- Azithromycin
- Furan/Nitrofurazone
- Kanaplex/Kanamycin
- Sulfaplex/Sulfathiazole
- Neoplex/Neomycin
- Tetracycline
- Metronidazole*
*Although Metronidazole is an antibiotic, it is mostly used as an antiprotozoal rather than an antibacterial, and is more acceptable for general use than the others. One of the active ingredients in General Cure.
When are they inappropriate to use?
Here's a quick rundown of when antibiotics should not be used:
- When you're unsure why your fish is sick. There are many types of infections: bacterial, fungal, parasitic... Just because your fish is sick does not mean it's a bacterial infection. There is a high likelihood your sick fish is not going to benefit from antibiotics anyway if you're not sure it's bacterial.
- When you haven't tried non-medication fixes first. A lot of sick fish are sick because of water quality, improper parameters, or stress, not because of an infection. An issue may come down to a soft water fish being in water that's too hard, or tropical fish looking drab and lethargic in cold water, or incompatible stocking, rather than a disease or infection. The infection will keep re-occurring if you never fix the root of the problem.
- When you haven't tried non-antibiotic treatments first. Keep antibiotics as a last resort. For example, clean water +- aquarium salt can (in most cases) clear up fin rot, one of the most common bacterial infections, without antibiotics. Epsom salt baths can clear up swim bladder disorder without antibiotics.
- When you want to dose preventatively when your fish aren't sick. I agree with preventative treatment! However, I absolutely, 100%, with every ounce of my being, do not believe in dosing antibiotics as a preventative. All you're doing is setting up your tank and your fish to be resistant when there might be a time down the road you do need to use antibiotics! Don't do it, I beg you! Quarantine your fish! Treat preventatively for parasites, if you must. Not for bacterial infections.
When are they appropriate to use?
- When you've ruled out easy fix issues like water quality. As we have all encountered at one point or another, beginners - through no fault of their own - may not be familiar with the nitrogen cycle, and are more likely to have water quality issues that cause illness. These beginners are also more likely to jump to grab antibiotics off the shelf and use them without second thought. Rule out these easy fix issues before checking off this box.
- When you are confident that your fish are sick because of a bacterial infection. When in doubt, ask! There are some fantastic aquarists on this forum who are always more than willing to help you diagnose and form a treatment plan for your fish.
- When you've exhausted all other treatments, and your fish still aren't healthy. The exception to this rule is when you're dealing with something that has a clear bacterial diagnosis, like Columnaris, and you are certain that (for example) an anti-parasite treatment is not worth trying first.
All of the above should be checked off before you proceed with antibiotic treatment.
"Do you just hate antibiotics?"
No! I believe antibiotics are some of the best medicines that humans have had the ingenuity to discover and create. They have saved countless numbers of people from certain death. That is why we need to use them mindfully and in moderation so that we will still be able to use them when they are medically necessary, and continue to save lives!
Thank you for reading! I hope you learned something new, and spread your new knowledge to those who seek your advice. Have a good day! Please feel free to ask questions!


