Antibiotic erythromycin in fish: Pharmacokinetics, effects, and health risks

Erythromycin is a macrolide antibiotic commonly utilized in veterinary medicine and aquaculture. It functions by binding to the 50S subunit of 70S ribosomes, inhibiting protein synthesis and effectively treating numerous bacterial diseases. Due to the extensive use of erythromycin, it has been detected in various aquatic systems in recent years. Multiple studies have reported the occurrence of erythromycin resistance and its adverse effects on diverse aquatic organisms. Consequently, potential environmental health risks associated with erythromycin have garnered increasing attention. As an integral component of aquatic ecosystems, fish have been the subject of numerous reports regarding the bioaccumulation and adverse effects of erythromycin; however, these data have not been collated and interpreted. This report provides a comprehensive overview of the environmental fate of erythromycin, detection methods, pharmacokinetics, and impacts on fish. In addition to the therapeutic benefits against pathogens, acute or chronic exposure of fish to erythromycin at concentrations ranging from μg/L to mg/L disrupts the primary defense, antioxidant, and xenobiotic metabolism systems, leading to oxidative stress, cellular structural damage, and metabolic disorders, manifesting as cytotoxicity, organ toxicity, neurotoxicity, developmental toxicity, and reproductive toxicity. However, further in-depth studies are warranted to evaluate the therapeutic efficacy at relatively high levels, particularly when considering pathogens with developed resistance to erythromycin, as well as the long-term effects of erythromycin exposure at environmentally relevant concentrations in fish, thereby better assessing the health risks posed by erythromycin to fish and their consumers humans.