Mouth rot is a patch of white stuff on a fish’s lips. As the disease advances it produces toxins that erode the lips of the fish. Advanced cases get very ugly and the fish can’t eat. Names for this disease include cotton-mouth, mouth fungus, and flexibacter.
This is most often gram-negative bacteria (columnaris, aeromonas, etc.). Many people mistakenly think this is caused by fungus. It isn’t.
It should be treated with broad-spectrum antibiotics (Midland Vet Service Aqua-Mox, VetDepot Amoxicillin, Fishbiotic Ampicillin, Mardel Maracyn 2, SeaChem KanaPlex, API Fin And Body Cure). These medications need to be obtained over the Internet as local stores have gone over to 100% high-profit margin “Natural” medications which are completely ineffective.
Bacterial infections are most effectively treated with antibiotics in the food. Many believe (and the instructions on the antibiotics say!) that antibiotics need to be added to the water. They are simply incorrect. This controversial topic is covered in the following link:
It is easy to make medicated food. Heat 1/4 cup water (two ounces or 58 milliliters, not a lot) in the microwave. Then blend seven grams of plain animal-derived gelatin (Knox gelatin, one packet) into the hot solution with vigorous stirring. Take two tablespoons of dry commercial fish food (pellets or flakes) and mix it with just a little of the hot water/ gelatin mixture. Add hot water/gelatin until you get a paste-like consistency. If it gets too watery just add more food. To get gel food to float simply mix in a little whipped cream at this point.
Then add just a “smidgen” (roughly 1/16 teaspoon, a 1% to 2% addition) of medication to the mud. If you are using more than one medication mix the medications together, then use just a “smidgen” of the mixture. If you are using a packet of medication, take just a “smidgen” of the packet’s contents. Mix and mash the whole mass thoroughly. Spread it out into a pancake about 1/8th inch (3 mm) thick on a plastic film or a plate. Then put in the refrigerator. If you plan on keeping it for more than two weeks put it in a small plastic bag and freeze.
All the fish in the aquarium should be fed a steady diet of antibiotic-laced food for at least ten days. Note that the exact amount of medication that goes into the food is not very important. Antibiotics can be overdosed pretty much with abandon as they are only toxic in large doses over a period of months. Note antibiotics in the food do not affect the filters so they can be left in place and operating.
If you can’t resist the urge to treat the water, remove the biofiltration media (including sponge and/or foam) in the filters and put it in an open container for the duration of the treatment. Sometimes antibiotics kill the beneficial bacteria and sometimes they don’t. In any case the filter media will denature the antibiotics. Monitor the ammonia and would do a 50% water change if it spikes above 1 ppm. Reduce the amount of food fed by 2/3 rds.
Note that if antibiotics are not available, it is quite easy to take a pill or capsule of human antibiotic and use it for fish. If it is a pill just grind it up. Just be aware that human antibiotics are about ten times more potent than aquarium antibiotics, so just a “smidgen” in the food is more than enough. This is a very good option for the folks in Europe or Canada, where fish antibiotics are illegal.
If one has fish with a bacterial disease, one must treat the whole aquarium. This is an emergency. Don’t fool around with herbs, tree leaf oils or some ineffective treatment. Ben Ochart treated a bacterial infection with Pimafix and Melafix. They did nothing to stop the infection. He lost a lot of large beautiful fish before he stopped the infection with antibiotics. This link covers the snake oil medications such as Melafix and Pimafix:
12.4.1. Natural Medications
The entire topic of bacterial infections in tropical aquarium fish is covered in more detail in this link:
10.3.11. Treating Bacteria
Source: Aquariumscience.org – David Bogert