The Future of Fish Antibiotics in Survival?

Siamese Fighting Fish (Betta splendens)

As the first physician to write, years ago, about aquarium and avian antibiotics as a survival tool, I’ve long realized their utility in preventing unnecessary deaths in true survival scenarios (in normal times, seek modern and standard medical care). Lately, I’ve received a lot of mail asking about the upcoming FDA Veterinary Feed Directive. Does it mean the end of the availability of fish and bird meds for placement in disaster medical storage?

To understand what the Veterinary Feed Directive is and what it means for the preparedness community, we should first describe the problem that the Directive aims to correct: Antibiotic resistance. There is an epidemic of antibiotic resistance in this country, and it exists, not because of pet bird or fish antibiotic use, not because “preppers” might put them in a disaster medical kit, nor even primarily from the overuse by physicians. It is due to the excessive use of antibiotics on livestock. About 80% of antibiotics used in the United States are given to food-producing animals.

The definition of a “Veterinary Feed Directive (VFD) drug”, according to section 504 of the FD&C Act (21 USC 354) states that it is “[a] drug intended for use in or on animal feed. The CDC’s goal #1 of decreasing the emergence of antibiotic resistance and preventing the spread of resistant infections has three objectives (see page 33):

1       -“Implement public health programs and reporting policies that advance antibiotic resistance prevention and foster antibiotic stewardship in healthcare settings and the community. “

2       -“Eliminate the use of medically important antibiotics for growth promotion in animals and bring other in-feed uses of antibiotics, for treatment and disease control and prevention of disease, under veterinary oversight. “

3       –“Identify and implement measures to foster stewardship of antibiotics in animals.”

As you can see, 2 of 3 of the above relate specifically to animals. Why are so many antibiotics given to livestock? It’s not, primarily, to treat infections that they may have. It’s actually because, for reasons that aren’t completely clear, it seems to speed their growth and gets them to market sooner. In other words, the profit motive. This is standard practice here in the U.S., but some countries, like Denmark, have banned the use of antibiotics on livestock unless they need them to treat disease.

The FDA and CDC are concerned about the excessive use of antibiotics in general and, in particular, on the animals that produce our food. CDC director Dr. Tom Frieden mentioned some months ago that an increased “stewardship” (in other words, control) of these meds was indicated to decrease the development of antibiotic resistance. The Veterinary Feed Directive is part of that response.

What are the drugs affected by the Veterinary Feed Directive? Here they are:

“Note: apramycin, carbomycin/oxytetracycline*, chlortetracycline/sulfamethazine*, streptomycin, sulfachloropyrazine, sulfachlorpyridazine, and sulfamerazine/sulfamethazine/sulfaquinoxaline* are expected to transition to Rx status, but are not marketed at this time. If they return to the market after January 1, 2017, they will require a prescription from a veterinarian.”

If you look at the list above, you’ll see no mention of the common aquarium/avian antibiotics used in the pet industry. Fish-Mox (Amoxicillin) is not included in the list. Neither is doxycycline, metronidazole, nor others that I’ve recommended for disaster storage. Some first-generation drugs, like Penicillin and Tetracycline, are mentioned but not any of the proprietary names related to the ornamental trade. That doesn’t mean that they might not include them at some point. As the earliest antibiotics, they have been subject to significant resistance, and might not be the best choices for survival storage in any case.

At present, Thomas Labs, one of the largest distributors of fish and bird antibiotics for the pet trade, has not visibly changed any of its policies regarding sale of these products. Their labeling clearly states “Not for Human Use”, and many sites that sell their products  include this statement:

“…Thomas Labs sources it’s (sic) antibiotics from the same USP grade manufacturing as antibiotics used for humans, but we and Thomas Labs are not doctors and do not deal in human health problems, or prescription medications.  Only a doctor can correctly prescribe antibiotics for specific need in humans.  We strongly discourage anyone who wants to take Fish Antibiotics for themselves…”

It seems clear that the Veterinary Feed Directive considers livestock and not hobby fish and birds to be the highest priority targets. If they did,  the pet trade might cease to exist.

The Veterinary Feed Directive may, indeed, decrease the incidence of bacterial resistance in the U.S. So will the wise use of antibiotics by the nation’s physicians. Hopefully, one day food livestock will be raised antibiotic-free; some companies are already taking this step.

From a preparedness standpoint, I still believe that having antibiotics in your medical kit will save lives in a long-term disaster or survival setting. The ones I have written about over the years are still available, at least for the time being; those medically responsible in times of trouble will find them to be useful tools in the medical woodshed.

Joe Alton, MD

Joe Alton, MD is a physician, author, and medical preparedness writer for disaster and long-term survival scenarios where medical help is not available for the foreseeable future. For more information on these and other topics, see the Altons’ #1 Amazon bestseller “The Survival Medicine Handbook: The Essential Guide for when Medical Help is Not on the Way“.