Please STOP CIPROFLOXACIN DIPS and other antibiotics

[brandon429]

Good link

Not one time in the history of cipro dosing did a real doctor prescribed it so an aquarist could take a guess to see if it might work for corals or anemones

Not one time in history did a cip user match it to a verified organism or sustain the complete course or do anything other than use a pill mill to get the meds, same for amoxicillin

 

[Rjmul]

I think we'll have to move on towards broad spectrum. Let's go with cefepime next. Onwards to meropenem.

Jokes aside, this is probably a stupid thing hobbyists are doing in and around their aquariums.

I'm not having it.

 

[gbroadbridge]

Good link

Not one time in the history of cipro dosing did a real doctor prescribed it so an aquarist could take a guess to see if it might work for corals or anemones

Not really true. I know of several real doctors who have prescribed antibiotics for aquariums when presented with supporting documentation.

 

[Cell]

I got a prescription from a local vet for Cipro a few years ago for a nem. He did ask for photo of the nem and proposed treatment protocol before prescribing and was a reefer himself so was somewhat familiar with the issue/treatment.

 

[brandon429]

I’ve been reefing twenty years and never needed it, nobody in my entire city of Lubbock ever needed it (I’m not in their homes to verify, per the reef meetings and online forum and pet stores where we traded actionable lore it was never ever even a thought) and I’ll never need it in the future. It’s possible to reef without it, because we have always done it that way. We aren’t restricted to certain anemones or sps, we can keep what we want.

Ive never seen it used at nano-reef.com either. I’m sure there has been a dose in the last few years, its the new trend for sure, but it’s not anything I’ve seen ever over there it’ll be highly isolated use if at all

Any doctor that prescribed it without a matched bacterial assessment is a quack. Nobody with credentials takes a guess with powerful antibiotics, having no idea at all if there’s another malady causing the issue, there could be twenty reasons an anemone doesn’t puff up.

what real doctors do is get a swab, plate it, grow the culture on agar for selection and for sure identify the target. they just don’t go get cipro, the doser of the year, they actually prescribe the matching antibiotic to the strain at hand. It has a set dose and sustain rate, which doesn’t exist for aquarium use only guesstimates guide aquarium use

I’ll also bet that was pre pandemic before supplies were at risk, but if it wasn’t, I can understand that too. Any doctor who prescribes a scrip for a powerful antibiotic off an aquarium picture has low standards. I once bought a scrip for testosterone in Acuna for ten bucks, at a bar, he was a real doctor no joke but I’m not sure his standards matched other doctors.

there are ways to change the approach to reefing where it is simply never needed and that’s the only way any of us should be reefing and researching and teaching others

 

[MnFish1]

I do not know if in your area it could be considered the ideal practice.

https://sidp.org/antibiotic-disposal

I believe pharmacies would not accept let's say 5 gallons of cipro containing water.

 

[MnFish1]

I do not know if in your area it could be considered the ideal practice.

https://sidp.org/antibiotic-disposal

That is a nice link - note their recommendations - Do not keep antibiotics on hand - and only use antibiotics prescribed for yourself (do not give them away)

 

[MnFish1]

I got a prescription from a local vet for Cipro a few years ago for a nem. He did ask for photo of the nem and proposed treatment protocol before prescribing and was a reefer himself so was somewhat familiar with the issue/treatment.

Just saying - this is illegal, FWIW. Not you asking, but him prescribing. Since I have a close relative thats a veterinarian, it is illegal for her to prescribe medications for our kids, and it's illegal for human MD's to prescribe medications except for a specific patient. (Human patient). I would disagree with Brandon - I wouldn't say he was a 'quack' - but per the law he was not using good sense, whether he was a reefer or not. Just my opinion - no offense

 

[Cell]

Yes I know. Ilegal prescriptions get written quite frequently. Lots of Doctors will make judgement calls. In this case, it was a vet prescribing for an animal, not a vet prescribing for a human though. Your examples are different scenarios.

 

[MnFish1]

there are ways to change the approach to reefing where it is simply never needed and that’s the only way any of us should be reefing and researching and teaching others

However this is the problem. IF the medication is NEEDED - there is no reason not to use it. For example - what way could be used (assuming cipro is the only drug that works to cure disease xxx) to change reefing or teaching others.

In other words - if there is a recognized disease and cause known - and an antibiotic is needed, I don't see any issue with using it - hopefully with a prescription. The problem is that RTN/STN/Anemone problems are likely multiple diseases with multiple causes. Merely throwing an antibiotic in the tank and then anecdotally noting improvement is not evidence that that antibiotic should be used every time a tank has the same symptoms.

For example. I can't call the doctor and say "I have a sore knee, I think I have Lyme disease, because I saw a tick on me a couple weeks ago" - and ask for an antibiotic, because the sore knee could get better on its own without the antibiotic, and there are multiple causes for sore knees. It would be my guess/opinion that an extremely high percentage of problems with coral relate to tank conditions rather than a primary bacterial issue attacking coral. Why? Because many reefers, when they start getting RTN, etc - cut off the affected limb - and it gets better.

 

[MnFish1]

Yes I know. Ilegal prescriptions get written quite frequently. Lots of Doctors will make judgement calls. In this case, it was a vet prescribing for an animal, not a vet prescribing for a human though. Your examples are different scenarios.

I apologize - I misread your post - I did not see 'local vet'. Instead I saw doc. If a vet prescribed the medication - with a picture - and a protocol - I don't see any issue with that - except if it was prophylactic treatment (as some people advise for anemones)

 

[MnFish1]

Not really true. I know of several real doctors who have prescribed antibiotics for aquariums when presented with supporting documentation.

This is what I was trying to say to @Cell. If it was a real 'veterinarian' thats fine. If it's a medical doctor (human) thats technically illegal (it's called practicing veterinary medicine without a license). My other question is 'what documentation' could possibly be provided to a human doctor who doesn't even know what a reef tank is that would justify prescribing cipro. All-in-all - its kind of a moot decision - since people can buy (supposed) cipro online for their fish - my comment would be 'who knows exactly what they're putting in their tanks?'

 

[Cell]

The problem is, there just isn't funding for research like this in our hobby. So we are left to our own devices, including hobbyist experiments and anecdotal information.

 

[MnFish1]

The problem is, there just isn't funding for research like this in our hobby. So we are left to our own devices, including hobbyist experiments and anecdotal information.

Except there are plenty of experiments going on with antibiotic treatment (with some success). Let's put it this way - they are not dumping cipro on the Great Barrier Reef - and many corals are recovering on their own. Let's pretend they had dumped cipro on the reef - everyone would be saying 'cipro saved the reef'. I think the topic has gone off a little off track. The key point was routinely dipping coral with antibiotics (or anemones, etc) - as compared to treating a disease.

@Jay Hemdal - curious about your take. If you had a huge (lets say 4000 gallon reef tanks) at your facility with sudden appearance of what appeared to be RTN of a contagious variety - what would you do?

 

[Cell]

I'd be curious to hear @Jay Hemdal thoughts on this subject.

I actually only have a personal opinion, as I don't have a background in human medicine.

So here it is: I virtually never use antibiotic baths to treat fish. I either don't use them at all, and see if the fish recovers on its own given supportive therapy (virtually all external bacterial infections are caused by a problem in the environment) or I dose orally or through injection. I will give advice to people here regarding antibiotic baths, because if I don't, somebody else will, and often do it poorly (grin). The only drugs I commonly suggest are:

Erythromycin for eye injuries
Neomycin for gram negative external infections
Kanamycin as a sub for above

For some reason, folks in Europe often use Enro/Cipro, so I'll give them a dose for that if they ask for it.

Back in my fish wholesale / retail days (late 70's), I used a whole suite of strong drugs: Nalidixic acid, sulfa/trimeth, etc. The physicians here will cringe, but I recall how my eyes would water and I would cough when mixing up chloramphenicol powder in aquariums...

Jay

 

[MnFish1]

@Jay Hemdal - what is your opinion about using antibiotics for coral infections. What do they do in your facility. I know you already posted about fish.

 

[Jay Hemdal]

@Jay Hemdal - what is your opinion about using antibiotics for coral infections. What do they do in your facility. I know you already posted about fish.

I haven't used antibiotic dips on cnidarians since 1986 (grin). We used to try that with anemones that arrived with damage....didn't work really well. Since then, I kind of just stopped trying. With the on-going coral recovery efforts in Florida, antibiotics for coral diseases are making a comeback, but I'm not involved with those projects.

Jay

 

[Jay Hemdal]

Except there are plenty of experiments going on with antibiotic treatment (with some success). Let's put it this way - they are not dumping cipro on the Great Barrier Reef - and many corals are recovering on their own. Let's pretend they had dumped cipro on the reef - everyone would be saying 'cipro saved the reef'. I think the topic has gone off a little off track. The key point was routinely dipping coral with antibiotics (or anemones, etc) - as compared to treating a disease.

@Jay Hemdal - curious about your take. If you had a huge (lets say 4000 gallon reef tanks) at your facility with sudden appearance of what appeared to be RTN of a contagious variety - what would you do?

We would just frag ahead of the issue and cull the infected portions of the colonies. Knock on wood, this has worked for the couple of times we've had this issue.

Jay

 

[Tony Thompson]

As I am from the UK , I was very surprised at the apparent ease (within the USA) at which certain controlled medicines can be acquired.

To obtain these products by way of bypassing regulated suppliers may lead to inferior products and incorrect dosage, which could create a major concern, especially with regards unwanted development of anti biotic resistant strains. Zoonotic disease transfer is also a concern that should not be discounted lightly.

For traders within the aquarium trade contemplating or currently offering supply of the medicines detailed below (but not limited to) you may be in contravention of the USA FDA regulations.

My initial concern was there seemed to be a lack of regulation on the part of the FDA, however after further investigation I found this from the FDA website in the USA.


Below is an extract , edited to highlight relevant (to this discussion) statements.








"Issuing Office: Center for Veterinary Medicine
United States

WARNING LETTER

Date: October 6, 2020

RE: Unapproved New Animal Drug Products

RE: [610530]


"The FDA has observed"

"for sale in the United States veterinary products for the use in aquarium species, including Chloroquine Phosphate products. The claims"

"that these products are drugs under Section 201(g) of the Federal Food, Drug and Cosmetic Act (FD&C Act) [21 U.S.C. § 321(g)] because they are intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in animals or because they are intended to affect the structure or function of the body of animals. Based on our review, as discussed below, these products are unapproved new animal drugs. An unapproved new animal drug is unsafe under section 512(a) of the FD&C Act [21 U.S.C. § 360b(a)] and adulterated under section 501(a)(5) of the FD&C Act [21 U.S.C. § 351(a)(5)]. Introducing or delivering for introduction into interstate commerce adulterated drugs violates section 301(a) of the FD&C Act [21 U.S.C. § 331(a)]."

"Statements on your website that establish the intended uses of your products include, but are not limited to, the following:"


"Oxolinic acid"

"Chloroquine Phosphate Powder"

"Doxycycline Hyclate"

"Erythromycin Powder"

"Kanamycin Sulfate"

"Metronidazole Powder"

"Neomycin Sulfate Powder"

"Nitrofurazone Powder"

"Oxytetracycline Hydrochloride Powder"

"Based on our review, your products are for use in ornamental aquarium fish species, which are minor species as defined by sections 201(nn) and (oo) of the FD&C Act [21 U.S.C. §§ 321(nn) and (oo)]. As drugs for minor species, they are considered “new animal drugs” under section 201(v) of the FD&C Act [21 U.S.C. § 321(v)] because they are not the subject of a final FDA regulation published through notice and comment rulemaking finding that the drug has been generally recognized among experts qualified by scientific training and experience to evaluate the safety and effectiveness of animal drugs, as safe and effective for use under the conditions prescribed, recommended, or suggested in the labeling. To be legally marketed, a new animal drug must have an approved new animal drug application, conditionally approved new animal drug application, or listing on the Index of Legally Marketed Unapproved New Animal Drugs for Minor Species (“index listing”) under section 512, 571, or 572 of the FD&C Act [21 U.S.C. § 360b, 360ccc, or 360ccc-1]. The animal drugs named above have not been approved, conditionally approved, or index listed. Animal drugs that lack the required approval or index listing are "unsafe" and "adulterated" under sections 512(a) and 501(a)(5) of the FD&C Act [21 U.S.C. §§ 360b(a) and 351(a)(5)]. Introduction of an adulterated animal drug into interstate commerce is prohibited under section 301(a) of the FD&C Act [21 U.S.C. § 331(a)]."

"This letter notifies you of our concerns and provides you an opportunity to address them. Failure to address this matter may lead to legal action without further notice, including, without limitation, seizure and injunction. You should notify this office, via e-mail, within the following timeframes, of the steps you are taking to correct any violations: Chloroquine Powder, Chloroquine Flake, and Chloroquine Pellets within two (2) working days of the receipt of this letter, all other products within fifteen (15) working days of the receipt of this letter. Include an explanation of each step being taken to prevent the recurrence of violations, as well as copies of related documentation. If you cannot complete corrective action within the above timeframes, state the reason for the delay and the time frame within which you will complete the correction. If you believe that your products are not in violation of the FD&C Act, please provide us with your reasoning and any supporting information for our consideration."



"Sincerely,

Mr. Eric M. Nelson
Director, Division of Compliance
Center for Veterinary Medicine
Food and Drug Administration"

Complete un edited letter can be found here https://www.fda.gov/inspections-com...ng-letters/everything-aquatic-610530-10062020

 

[Tony Thompson]

According to the company - it is a 'trade secret'.
The product is apparently now available in the EU - so if there was a ban - it seems to be corrected?

The term EU may possibly be a little misleading. As even within the European Union Members States, regulation on the supply of anti biotics varies between countries. However Importation has a completely different set of regulations that covers the qualifying full member states.

This is also evident between sperate countries within the European continent.

As a general guide It is my experience that the countries such as (but not limited to) the Netherlands, Belgium, Germany, France and The United Kingdom of England , Scotland, Wales and Northern Ireland have the more robust restrictions.

As of date, I am unaware of the legal supply of the Boyde enterprises product mentioned, within those countries mentioned above. However there are other products, described for use against cyano bacteria that are on general sale in the UK.