Amazon reviews for Fish Mox, an antibiotic for pet fish, have turned into commentary on the state of American healthcare by Twitter users as it was discovered that people are self-medicating with their pet’s antibiotics rather than going to a doctor.

Read the reviews for aquarium antibiotics and decide for yourself.

— Rachel 🦈 Sharp (@WrrrdNrrrdGrrrl) July 30, 2017

“My fish came down with a nasty case of bronchitis and sinusitis just before Christmas, but her health insurance doesn't kick in until the first of the year,” one reviewer wrote. “She couldn't go to a fish doctor because she only makes minimum wage at the aquarium, and a trip to the fish emergency room would have put her in debt.”

“These are the exact same antibiotics you would get from your doctor,” another reviewer noted.

Fish antibiotics, which are available without a prescription, are a popular subject on websites for “survivalists” and a “poverty tips” subreddit.

Megan McSeveney, a press officer with the US Food and Drug Administration [FDA], strongly advised consumers not to use fish antibiotics as a substitute for prescription medication intended for human use, noting that these pills have not been evaluated by the FDA.

“The antibiotics available in pet stores or online for ornamental fish have not been approved, conditionally approved, or indexed by the FDA, so it is illegal to market them,” McSeveney said. “If consumers are seeing these products in stores, they should be aware that these products have no assurance of purity, safety or effectiveness.”

According to the World Health Organization, more than 50 percent of antibiotics worldwide are purchased privately without a prescription.

According to the Centers for Disease Control and Prevention, taking unprescribed antibiotics may not even treat your illness, as many common illnesses are the result of viruses, not bacteria. Misuse or overuse of antibiotics may also increase your chances of developing an antibiotic-resistant infection.

“Each year in the United States, at least two million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections,” the CDC reports.

Aquarium antibiotics are just one in a long list of health treatments promoted by survivalists and home remedy devotees. Other popular over-the-counter remedies include colloidal silver, garlic oil, and goldenseal.

But self-medicating is incredibly dangerous, according to a report by the Department of Biological Sciences at the National University of La Plata. Risks of self-medicating include “incorrect self-diagnosis, delays in seeking medical advice when needed, infrequent but severe adverse reactions, dangerous drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice of therapy, masking of a severe disease and risk of dependence and abuse."

While some survivalists tout the benefits of colloidal silver, the FDA declared in 1999 that colloidal silver products are neither safe nor effective — there are no proven benefits, but misuse can lead to argyria, a condition caused by excessive exposure to silver which turns the skin bluish-grey.

Garlic, meanwhile, can increase your risk of bleeding when taken with blood-thinning drugs, while goldenseal may increase your blood pressure and has been associated with heart rhythm abnormalities, according to the Cleveland Clinic.

Verify sources:
Megan McSeveney, a press officer with the US Food and Drug Administration

Verify resources:
Reviews for Fish Mox
Centers for Disease Control and Prevention FAQ on antibiotic use
World Health Organization report
CDC report on use of unprescribed antibiotics
Cleveland Clinic warning on herbal remedies