Protocol for using antibiotics to treat infected anemones ~Added to 7/30/14

[TinManx]

Originally Posted by MachPilot

In a perfect world, dripping vancomycin would be THE definitive drug of choice for any anemone/invert but its not available outside of the hospital and requires dripping and maintenance of peaks and troughs.

I sincerely hope that you are joking I am sorry, but no reef creature is worth utilizing the LAST LINE of defense that humans have against life threatening infections. I am thankful vancamycin is protected from reckless prescription. Hopefully no reef addicts try and grab some on the black market....

[hypnoj]

lol.. This thread has turned pretty funny. Anyone have tips on how/where to insert an IV into my nem? I'm not letting this guy go down without a fight!!

[OrionN]

Originally Posted by hypnoj

lol.. This thread has turned pretty funny. Anyone have tips on how/where to insert an IV into my nem? I'm not letting this guy go down without a fight!!

Just get a needle and stick it in there. Now tape the IV to keep it on the anemone can be a problem, but we fight that battle when we get to it.

Seriously. Vancomycin is only effective again gram possitive organism and would not be an ideal antibiotic use to treat anemone infection unless I completly miss the boat. It have very narow spectrum of activity and very good for certain infection but hardly the last line of defense for human.

[OrionN]

Just for kick, Vancomycing is very expensive, even generic. It hav ebeen out since the 1950's
Pricing: U.S. Dose abour 500-1000 mg per day
Capsules (Vancocin HCl Oral)
125 mg (1): $34.82
250 mg (1): $64.20
Capsules (Vancomycin HCl Oral)
125 mg (20): $626.12
250 mg (20): $1154.32

[TinManx]

Originally Posted by OrionN

but hardly the last line of defense for human.

Perhaps I am misguided. What is considered the last line of defense against MDR infections then?

[OrionN]

Depends on the infections. We culture them out and then use antibiotic that it is sensitive to. There are enterococcus strains (one of the Gram possitive cocci) that is resistant even to Vacomycin. There are a few newer medication we can use but all we can do is isolate Pt treat them with what we can and hope for the best.

Often highly resistant oragnisms spend a lot of their energy maintian the resitant (they have to produce a lot of factors that keep them drug registant) and not really invasive other than for weaken pt with weaken immune system. Here is a reasonable article regarding Vancomycin Registant Entercoccus (VRE)

http://www.webmd.com/a-to-z-guides/v...i-vre-overview

[hypnoj]

OrionN is correct, Vanc is hardly last defense and there are way better abx out there right now depending on what's cultured. Vanc is just cheap and easy and works pretty good for MRSA etc.
However, I think we should get back on track with this topic and begin discussing medications for water-born bacteria that can infect anemones. (I know I contributed to the foolishness too

[TinManx]

Originally Posted by hypnoj

OrionN is correct, Vanc is hardly last defense and there are way better abx out there right now depending on what's cultured. Vanc is just cheap and easy and works pretty good for MRSA etc.
However, I think we should get back on track with this topic and begin discussing medications for water-born bacteria that can infect anemones. (I know I contributed to the foolishness too

Thanks for the clarification. I am not an M.D., so i need some education sometimes. But there is certainly some merit to my stance on vanc, as evidenced by the guidlines for its use set forth by the CDC:

http://wonder.cdc.gov/wonder/prevgui...9/m0039349.asp

As part of the discussion, it would be interesting to see what antibacterial treatments others have tried. So far I only have only heard of cipro and spectrum ds.

[MachPilot]

Going to set up a vanc drip!....

Ugh this hobby gets more involved by the second lol

[tassy]

Hello all.

Speaking of getting back on track with the disscussion of medications for water born bacteria. I did a post about a week ago with different meds and possible dossages. And i do believe that because of my post count, little info was offered.If we want people to try different meds then lets offer a little help. FYI I lost all my password stuff and or for got, and have been on here under diff names. Been in salt since FFEand stocked my 1st tank with them.


peaceout

John

[OrionN]

I am not sure if MachPilot is serious so this may not be needed. While Vancomycin is not the last line of defense for human it is a very important antibiotic. However I do not think that it is an appropriate antibiotic for anemone or fish infection since it only effective against gram positive organism.
Hospitals all have appropriate protocol to ensure it's use is appropriate. I think using IV vancomycin for fish tank is consider very inappropriate. In addition getting IV vancomycin cannot be easy. IMO it also have a wrong spectrum of activity for our need

[Reefahholic]

Originally Posted by OrionN

I am not sure if MachPilot is serious so this may not be needed. While Vancomycin is not the last line of defense for human it is a very important antibiotic. However I do not think that it is an appropriate antibiotic for anemone or fish infection since it only effective against gram positive organism.
Hospitals all have appropriate protocol to ensure it's use is appropriate. I think using IV vancomycin for fish tank is consider very inappropriate. In addition getting IV vancomycin cannot be easy. IMO it also have a wrong spectrum of activity for our need

Vancomycin is the wrong antibiotic for anemones. There are much more affective antibiotics that will work a lot better.

[hypnoj]

don't worry guys, we were just kidding about the Vancomycin

[Amoo]

Maybe I'm confused here, but why would one need to inject the Nem with Vanomycin? If I have my understanding correct, our nems internals are filled with whatever we fill the water column with. They don't have kidneys to dispel the medication like humans do, so I would think it would be just as effective in the water column, with far less stress to the nem, then trying to IV a nem. If this works with Cipro, why wouldn't it work with Vanco?

[M Woodhill]

Originally Posted by KCFITZ78

Does Erythromycin work?

Nope. I tried on my ritteri and basically saw no improvement

[Enrico Rj]

I didn't head all the comments, but about use the UV light together ?!

[dmmdlaw]

Is it ok to treat with cipro in tank with fish and other creatures?

[OrionN]

Originally Posted by dmmdlaw

Is it ok to treat with cipro in tank with fish and other creatures?

We should not use broad spectrum antibiotic in a reef/marine tank. These tanks use bacterial as the main filtration method. These antibiotic will cause a lot of unpredictable changes in the bacterial population.
IMO, we should not use antibiotic at all in a marine or reef tank, but definitely not broad spectrum antibiotic.

[Jilnifer]

I bought a Haddoni carpet over a month ago. Within a week, his mouth was gaping. I moved him to a HT and administered Cipro for 7 days. It looked better and was moved back to DT a few days later. After a couple of weeks his mouth is gaping again and he is deflating daily. Should I try Cipro treatment again? Any other suggestions on how to save him?

[Jilnifer]

Bump

I need some help, please!

[OrionN]

I would treat again, maybe use Septra DS this time.
Check your tank condition, healthy anemone normally do not get sick out of the blue. Something cause the problem and get him sick. You may not keep him healthy long term unless you fix this. Often just frequent large water change will get the chemistry back to normal and get rid of "bad stuff" that cause them to be sick.

[Amoo]

Minh,

Any reason you haven't taken a shot with Cefotaxime? I know when plants have gram + infections they treat with vanco, but for gram - they treat with Cefotaxime.

[OrionN]

Cefotaxime is a Cephalosporin antibiotic, third generation. This group the spectrum are mostly gram + intil third generation. Most of these Ceph. third generation drugs are expensive and IV only. Cefotaxime is IV or IM only, not oral thus come only in powder for mixing IV. It cost about 2.50-3.50 per dose
I did not use these because they are harder to get and are more expensive. They are not usually available in outpatient pharmacy since they are only use in the inpatient setting.

[Amoo]

It's actually generally inexpensive $3.50 for 10ml of 500mg/ml. I do understand that it is meant for IM or IV use, but this still goes back to my earlier comment about Vanco, as long as we're suspending it in the water column it's going to get into the Nem's body. Beyond that, we don't know much more about what it's reactions could be as we do with a "normally" oral medication like Cipro.

Maybe I need to look up the method of delivery for plants, but I feel it's an unexplored option with something with a little more coverage, or at least different coverage, than Cipro is currently giving us.

Edit:

This site seems to have a pretty solid list of what we have potentially at our disposal. There's not much I can think of that we use in the vet industry on a daily basis that isn't listed here:

http://www.phytotechlab.com/pdf/antibiotics.pdf

[OrionN]

It certainly harder to come by. I treat Human so I do not know much about what is available for researcher or Vet. The following is my information about pricin gof cefotaxime from uptodate.com, a professional medical information site that I use a lot.

I try to use medication that is cheap and easily available. If what we usually use does not work then we can expand to different antibiotic. Cephotaxime can be use and it should be effective. I would use 1000 mg per 10 liter. If you use it, please post so we can all gain some experience. These are wholesale price. Pharmacy will add their profit on top of this. AWP is Average Wholesale Price

Quote from uptodate.com
Pricing: U.S.
Solution (Claforan in D5W Intravenous)
1 gm/50 mL (50 mL): $16.15
2 gm/50 mL (50 mL): $28.54
Solution (reconstituted) (Cefotaxime Sodium Injection)
1 g (1): $2.64
2 g (1): $13.00
10 g (1): $65.00
500 mg (1): $6.38
Solution (reconstituted) (Claforan Injection)
1 g (1): $2.06
2 g (1): $5.05
10 g (1): $22.68
500 mg (1): $1.80
Solution (reconstituted) (Claforan Intravenous)
1 g (1): $4.04
2 g (1): $7.32
Disclaimer: The pricing data provide a representative AWP and/or AAWP price from a single manufacturer of the brand and/or generic product, respectively. The pricing data should be used for benchmarking purposes only, and as such should not be used to set or adjudicate any prices for reimbursement or purchasing functions. Pricing data is updated monthly.