I asked the editor of The Survival Doctor, Leigh Ann Hubbard (a professional journalist and my daughter), to investigate fish antibiotics for use in humans. Here’s her in-depth report. (Don’t miss our related report: Do antibiotic expiration dates matter?)
by Leigh Ann Hubbard
But there are a few must-have lifesavers nothing can replace. One is oral antibiotics.
When antibiotics came on the scene in the 1940s, they changed the world. Suddenly, with one little medicine—penicillin at the time—more people could survive serious bacterial infections like staph and strep. Antibiotics brought hope, health, and life.
Today, we have many types of antibiotics that work for different bacterial infections. If we lost access to them, we’d revert to the time when people died for lack of a pill. So it’s common for preppers to stock up on a round.
The challenge is these meds are only available through prescription. Some doctors will prescribe antibiotics for survival storage. But another option many preppers explore is fish antibiotics. They’re commonly sold in human doses and available without a prescription.
Despite the fact that buying these meds is common, preppers struggle to find an answer to this seemingly simple question: Are fish antibiotics safe and effective for humans? The only answers provided thus far have been speculative.
So we decided to delve into the topic, The Survival Doctor style, seeking evidence and expert insight. We spent weeks contacting pharmacists, drug manufacturers, veterinarians, and safety watchers. We located key experts who shared invaluable, never-before-reported information—some on the record, some off.
Interestingly, many other people wouldn’t speak at all on this topic. Granted, it’s one most experts haven’t looked into, and it’s controversial because of antibiotic resistance and other potential dangers of using antibiotics without a doctor’s guidance.
But the surprising reason some people wouldn’t speak on the record is companies selling fish antibiotics are walking a fine legal line. And this fact affects how safe and effective these drugs may be—for fish and humans.
General Tips for Using Animal Drugs
Before delving into murky waters, let’s start with some general guidelines. Say you get your hands on a medication—antibiotics or not—that’s approved by the Food and Drug Administration for use in animals. Will it work for you too?
First, keep in mind that animal doses may be different from human ones. So make sure you have the correct human dosage. Also confirm that the medication can be safely used in humans. (Some animal meds aren’t safe for humans, and some go by different names than the human ones, so make sure you’re not allergic.)
If you’ve satisfied these two requirements, you still have a couple of other things to consider. Namely, even animal drugs that have the same name as human drugs may not be exactly the same. For example:
- FDA regulations for animal and human drugs are determined separately. Animal drugs may contain fillers, additives, and impurities that aren’t allowed in human medications.
- Medications are manufactured to absorb just right in the type of body they’re approved for. A cow has two stomachs. A chicken has a gizzard. A fish is tiny.
It’s up to you whether to take the med, but for an expert opinion, we asked pharmacist Jim Budde, president of the Society of Veterinary Hospital Pharmacists, if he’d take such a medicine. He says if it were FDA approved for dogs or cats and it was safe for people, yes, he would feel comfortable taking it.
But now’s the time we wade into those murky waters. Note that he said he’d take a product that was FDA approved. Believe it or not, there are no such antibiotics for ornamental fish.
Antibiotics or Cornstarch?
Yes, those popular antibiotics that are sold online for ornamental fish are actually not FDA approved, even for the fish. In fact, marketing these drugs for use in fish is illegal, according to an FDA source we spoke with. So is selling them in stores, the source said. (Preppers usually order these drugs online).
Therefore, there is no government oversight regarding the safety, purity or effectiveness of fish antibiotics. Budde likens the lack of FDA scrutiny to that of nutritional supplements: there is no guarantee that the pills contain what the manufacturers say they do, either in amount or purity.
For example, in the case of a 250-milligram capsule of amoxicillin, “There could be nothing in there—meaning no active ingredient. It could just be a bunch of cornstarch or other inert ingredient. Or it could have some amoxicillin but not 250 milligrams,” Budde says. “There could also be impurities in there that would cause harm when taken.”
In addition, the medication may not absorb correctly. A drug must be manufactured properly to absorb properly. For example, some should melt immediately in the mouth; some should dissolve in the stomach; and others must survive the stomach and dissolve in the intestines.
Budde acknowledges that some preppers don’t care too much about government scrutiny, but he notes, “That’s kind of the whole purpose of the FDA. It was created to ensure safe and effective medications. It’s the premise of the whole pharmaceutical industry these days—that what they make is pure.”
“USP Certified”? Not Really.
Some online prepper articles about fish antibiotics speculate that you can get around this lack of FDA oversight by making sure the pills are “pharmaceutical grade” and/or “USP certified.” Yet we found that neither of these terms means much when it comes to fish antibiotics.
“If it says ‘pharmaceutical grade,’ I personally wouldn’t know necessarily what to make of that,” Budde says. Neither would the FDA, which doesn’t regulate or define the term for animal drugs (or for human supplements, where it also often appears on labels).
“USP certified” seems more promising at first—until you look into the details.
The United States Pharmacopeial Convention is a nonprofit organization that sets quality guidelines for medications. They don’t assess whether a drug is effective or safe; they do set standards for things like storage, purity, and strength. To be sold in the U.S., a drug must pass these standards.
We could find no antibiotics for ornamental fish that are USP verified.
However, there are fish antibiotics whose appearance is identical to USP grade human antibiotics. They have the same coloring and imprints (codes printed on the pills), suggesting that they are, in fact, the same capsules.
We contacted one popular company that sells such fish meds. A representative, who asked not to be identified, confirmed that they are the same pills. They’re sourced from a manufacturer that makes them for humans, the representative said. The fish company repackages them.
Still, this does not mean the antibiotics are USP grade, even when a company claims they are.
That’s because, to be USP grade, the pill has to meet every USP standard for that medication. And the standards go far beyond ingredients. They also ensure medications are packaged, labeled, and stored correctly. For example:
- Antibiotics are sensitive to heat, so they must be stored at room temperature. (Consider the shipment temperature as well as conditions in facility storage.)
- Antibiotics are sensitive to moisture, so they must be stored in tight containers.
- The pills must be tested to make sure they don’t have bacteria, mold, or yeast.
- The packaging material must not interfere with the drug. For example, plastic shouldn’t absorb into the pill, nor the medication into the plastic.
The USP also has labeling standards, requiring certain warnings and guidelines to be displayed.
Finally, there’s the issue of expiration, which is especially a concern if a medication isn’t stored or shipped optimally. With no FDA oversight, there’s no guarantee of how old a medicine is.
Considering all these things, any fish antibiotic could pose problems to humans. Perhaps the biggest concern is its effectiveness may be reduced. In that case, the med may not work on your infection—or it could weaken the infection, only to have it resurge as an antibiotic-resistant version.
The Gamble You May Not Have to Take
All this is not to say fish antibiotics would never work for or be safe in humans. If you had no other option, and you were certain you were not allergic to the fish antibiotic you got your hands on, it would be up to you whether to try it.
The point is, it would be a gamble. And antibiotics aren’t something you want to gamble with if you can at all help it because a life may be at stake.
If you’re planning for a time when you can’t get to a doctor and you’re going to store antibiotics, your best bet is to store human ones so you never have to make that choice. Generic human antibiotics are cheap, and some doctors will prescribe a round if you explain what it’s for.
However, with this power comes this responsibility: a personal stash of antibiotics should only be used carefully, knowledgeably, and as a last resort. In normal circumstances, if you can get to a doctor before taking antibiotics, do. This helps you avoid dangerous side effects, interactions, and antibiotic resistance. The doctor will also decide whether antibiotics will likely work on your infection (they won’t if it’s viral) and which of the many types of antibiotics is your best bet.
We are fortunate to live in a time when we have access to these life-saving medications. We don’t yet have to decide whether what’s good enough for a guppy is good enough for us. If we ever do have to make that choice, at least we can do it knowledgeably, having learned the facts, not just the speculation.
Leigh Ann Hubbard has been a health journalist for over a decade. She’s the editor of TheSurvivalDoctor.com and the owner of Revolutionary Writing Consultants, a writing agency specializing in health.
Don’t miss our related report: Do antibiotic expiration dates matter?