Protocol for using antibiotics to treat infected anemones

OrionN

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This is a re-post of what I wrote in ReefCentral on 3/09/2013

Many anemone keepers know, the collection and shipping process from ocean to local fish store (LFS) is a stressful event. Most host anemones do not survive this process without help, especially H. magnifica and S. gigantea. Other host anemones also have high mortality. Most succumb to infection in the first 4 weeks on arrival to LFS. With help from other anemone keepers at ReefCentral.com Anemones and Clownfish Forum, I have come up with an antibiotic protocol that seems to be successful and drastically improve the initial survival of anemones during this critical time.

The antibiotic choice: Ciprofloxacin (Cipro), a floroquinone antibiotic or Trimethoprim/sulfamethoxazole (Septra) combination antibiotic
There are several reasons I choose these antibiotics. They are broad spectrum antibiotics that should, hopefully, cover most pathogens involved. These antibiotics covered most of the pathogens involved in a saltwater wound infection in humans. This is not to say that pathogen that infected the anemones are the same ones that infected human. However, we have to start somewhere and these two antibiotic are reasonable choices. The other reason for choosing these antibiotic is that they are inexpensive and widely available. Cipro and Septra dissolve well in water and will break down with light exposure in a tank environment. Another antibiotic that can be use is levofloxacin (Levaquin). However, Levaquin is a newer fluroquinone and much more expensive because generic are not available.


Instruction:
The dosage for continuous exposure (not dipping) in a hospital tank is Cipro 250 mg or Septra 160/800 mg per every 10 gal of water. I recommended that anemone be treated in hospital tank. I used a standard 20 gallon (high) tank, power head (PH) , heater, egg crate and possibly an air stone. I also recommended that full light is provide for the anemone to help it recover via photosynthesis. The hospital tank is divide into two compartments by the egg crate. Place the anemone with an inert object (a mug or a medium piece of rock) for it to attach to in one compartment. In the other compartment place the heater, PH and +/-air stone.
Fill the hospital tank half way (10 gal) and added either Septra or Cipro, then added the sick anemone. The hospital tank water needs to be keep stable with respect to temperature and salinity. I recommend that all the water in hospital tank be change daily as the day-time cycle comes to an end. After a water change add antibiotic. The best method to add antibiotic into the hospital tank is to rub the tablet between thumb and index finger in front of the PH until fully dissolved. With reasonable light, it is likely that all or most of the antibiotic will be degraded by the end of the day-time cycle. Adding medication at the begin of the night-time cycle, should give optimal antibiotic exposure for the anemone for most of the 24 hour time period. Adequate circulation, with small PH, is a must. The hospital tank will have a minimal ability to process ammonia, therefore feeding sick anemone is not recommended during treatment process. I do not recommend tapering the dosage of the antibiotic because low level antibiotic treatment is what causes problems and creates resistant strains of bacteria.
Anemones often discharge various substance when they are not well. When the hospital tank water have solid discharge, I recommend removal of these discharge. At any time, if the water of the hospital tank is cloudy, I recommend a 100% water change and new antibiotic added.

Length of treatment:
It is recommended that the anemone is treated for a minimum of 7 days, and at least 3 days after it stops deflating. Early termination of treatment is a mistake that has caused me to loose a few anemones.

Disposal of antibiotic containing water:
There is no special treatment needed for disposing water containing antibiotics. Cipro and Septra will break down quickly with light exposure and will not stay around long in the environment. Short course of antibiotic use like in this protocol should not have significant impact on the environment. It is harmful for the environment if there is a continuous low level antibiotic discharge, but not for short courses like in this protocol . In human usage, these two antibiotics are eliminated unchanged by the kidney, and flushed down the toilet into the sewage system, which is what we are doing with our treatment water. It is unclear if treatment by bleach will do anything to the antibiotic. If you are concerned, store the water and put it under sunlight for a few days then discard.
I clean the hospital tank and all equipment thoroughly include bleaching the full set up in fresh water. Once thoroughly cleaned, the hospital tank can be dry and put into storage until needed.
 

Reefing_addiction

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I am currently on day two of this treatment with my BTA the next 5 days (minimum) is going to be rough on me with work but I’ll do anything to try and make him happy and healthy again.
I bought cipro through chewy. It was NOT a prescription! Cost me about 40 with shipping. 30 pills 500mg each
 
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OrionN

OrionN

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I am currently on day two of this treatment with my BTA the next 5 days (minimum) is going to be rough on me with work but I’ll do anything to try and make him happy and healthy again.
I bought cipro through chewy. It was NOT a prescription! Cost me about 40 with shipping. 30 pills 500mg each
@dyerrm ,
Good luck with your BD present.
 

brandon429

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why would someone dose antibiotics to a system without verifying the species at hand/details via plating/incubation etc

not denying its a widespread practice but its also possible to keep bta's without dosing cipro when they deflate

clearly anything that stays active this long in practice gets results, but I was amazed at broadcast application of cipro / antibiotics with no verification of target, only polyp behavior. they typically try and be exacting and conservative in antibiotic use but that could be just old school info not sure. going off online patterns this seems to time with their inflation for sure.
 

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why would someone dose antibiotics to a system without verifying the species at hand/details via plating/incubation etc

not denying its a widespread practice but its also possible to keep bta's without dosing cipro when they deflate

clearly anything that stays active this long in practice gets results, but I was amazed at broadcast application of cipro / antibiotics with no verification of target, only polyp behavior. they typically try and be exacting and conservative in antibiotic use but that could be just old school info not sure. going off online patterns this seems to time with their inflation for sure.
My nem was showing filaments not only through his mouth but oral disk. After a week in confinement within the tank he was still going through Extended periods of time deflated mouth gaping. I have decided to run the Cipro treatment to see if I can help him. Obviously there’s no fish doctors or an enemy doctors she can properly diagnose a bacterial infection but when we’re talking about our pets we want to try anything to make sure they’re happy and healthy.
 

brandon429

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it shows to be working in pattern agreed, there are many others running it from searches that's been interesting to read about for our hobby.
 
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OrionN

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why would someone dose antibiotics to a system without verifying the species at hand/details via plating/incubation etc

not denying its a widespread practice but its also possible to keep bta's without dosing cipro when they deflate

clearly anything that stays active this long in practice gets results, but I was amazed at broadcast application of cipro / antibiotics with no verification of target, only polyp behavior. they typically try and be exacting and conservative in antibiotic use but that could be just old school info not sure. going off online patterns this seems to time with their inflation for sure.
So the sea water is full of bacterial. How are you going to obtain the sample without get it contaminated? Is there a lab that you can get your sample too? What happen to the anemone once you took a chunk off of it to get culture and over 3-4 days that you wait until you get the result? How much is the collecting in sterile equipment and culture solution and the plating and testing for antibiotic sensitivity going to cost you?
I considered this to do the study. I can tell you that each specimens going to cost me a lot, around $200.00

That is why we do empiric treatment.
It is easy to say “you should do this and this and this...” without thinking it through.
Just getting a sample without just pulverized the anemone and culture that juice take a whole lot of thought.
Even just pulverizing the anemone and culture it take a lot of thought. How to do it in such a way that we actually culture the pathogen instead of the contamination.
 

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My nem is showing improvement. Yay! Tonight was dose 4. I’m going to treat for 7 days. On Sunday I will change the water and give him one more full day in isolation.
Saturday and Sunday are my only two days home where I can observe and make sure he is not deflating. Friday my bf can watch him but I’ll have to remind him to check on him. I’m crossing my fingers that Monday I can stick him back in dt tank.
 

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Question on this. If the anemone goes back to its original tank, what prevents the bacteria from reinfecting once back in the tank.

I also noted these instructions are different from the other thread that has 100% water changes done every 12 hours for the first 36 hours I believe.
 

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Question on this. If the anemone goes back to its original tank, what prevents the bacteria from reinfecting once back in the tank.

I also noted these instructions are different from the other thread that has 100% water changes done every 12 hours for the first 36 hours I believe.
I think the reason to do 100% each day is to keep water parameters in check. To remove any waste the nem expels ( mine did expel things each day so far. It is also a good idea to wipe out the inside of the treatment tank.

I don’t have an answer for your first question.

But I believe most internal bacterial infections may have come from food fed to the nem or water it was in during transportation. it’s natural immune response was weakened. Just my thoughts on this last part
Maybe @OrionN can will have a better answer
 

flampton

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why would someone dose antibiotics to a system without verifying the species at hand/details via plating/incubation etc

not denying its a widespread practice but its also possible to keep bta's without dosing cipro when they deflate

clearly anything that stays active this long in practice gets results, but I was amazed at broadcast application of cipro / antibiotics with no verification of target, only polyp behavior. they typically try and be exacting and conservative in antibiotic use but that could be just old school info not sure. going off online patterns this seems to time with their inflation for sure.
So the sea water is full of bacterial. How are you going to obtain the sample without get it contaminated? Is there a lab that you can get your sample too? What happen to the anemone once you took a chunk off of it to get culture and over 3-4 days that you wait until you get the result? How much is the collecting in sterile equipment and culture solution and the plating and testing for antibiotic sensitivity going to cost you?
I considered this to do the study. I can tell you that each specimens going to cost me a lot, around $200.00

That is why we do empiric treatment.
It is easy to say “you should do this and this and this...” without thinking it through.
Just getting a sample without just pulverized the anemone and culture that juice take a whole lot of thought.
Even just pulverizing the anemone and culture it take a lot of thought. How to do it in such a way that we actually culture the pathogen instead of the contamination.

Okay in practice you would want all that and more. In reality its impossible without funding. So as someone who studies antibacterial resistance for a living, well this practice is pretty harmless if the proper precautions are put in place. Use gloves when handling the anenome and the treated water. Dispose of gloves before touching anything else. Dispose of the water when done and bleach the container.

Cipro is a hammer... Good choice!
 

Jeeperz

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Okay in practice you would want all that and more. In reality its impossible without funding. So as someone who studies antibacterial resistance for a living, well this practice is pretty harmless if the proper precautions are put in place. Use gloves when handling the anenome and the treated water. Dispose of gloves before touching anything else. Dispose of the water when done and bleach the container.

Cipro is a hammer... Good choice!
Maybe a link to the proper way to remove disposable gloves to prevent cross contamination would be helpful, not everyone knows how.

My nems were not shipped, have had the parent for 3 years. But in the last couple months have gone down hill, possibly due to algae issues
 

flampton

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Shooter6

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Maybe a link to the proper way to remove disposable gloves to prevent cross contamination would be helpful, not everyone knows how.

My nems were not shipped, have had the parent for 3 years. But in the last couple months have gone down hill, possibly due to algae issues
Did you recently treat for algae with reef flux?
 

flampton

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Not being bossy but if you are going to promote something potentially harmful and the safety behind it, back it up.

I did not promote anything. I said if you're going attempt to save an animal's life with antibiotics you should do it right. Geez. Btw If you don't already have this knowledge or are willing to study how yourself you shouldn't be touching antibiotics.
 

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