Breaking Antibiotic Dependency in Aquaculture: Evaluating Alternative Disease Management Strategies for Sustainable Aquaculture in Bangladesh

The rapid expansion of aquaculture in Bangladesh has substantially increased national fish production but has simultaneously intensified dependence on antibiotics for disease prevention and treatment, thereby accelerating the emergence and dissemination of antimicrobial resistance (AMR). This review critically evaluates the current landscape of antibiotic use, AMR prevalence, and the potential of non-antibiotic disease management strategies to foster sustainable and antibiotic-sparing aquaculture systems in Bangladesh. A structured evidence synthesis was conducted following the Joanna Briggs Institute guidance, drawing on peer-reviewed and gray literature published. The synthesis reveals widespread empirical and often unregulated antibiotic application across freshwater and brackish-water systems, accompanied by high frequencies of multidrug-resistant bacterial isolates and detectable antibiotic residues in cultured fish and surrounding environments. These patterns underscore significant risks to food safety, ecosystem integrity, and public health. In contrast, a broad spectrum of alternative approaches, including probiotics, prebiotics, synbiotics, phytobiotics, immunostimulants, vaccines, and nanoparticle-based interventions, demonstrate strong experimental efficacy in enhancing host immunity, modulating gut microbiota, reducing pathogen load, and improving survival and growth metrics. An adapted technology readiness perspective indicates that probiotics and synbiotics possess the highest practical maturity, whereas phytobiotics and immunostimulants show promising but inconsistent field performance, and nanotechnology-based solutions largely remain at pilot or laboratory stages in Bangladesh. The principal barrier to transition is therefore not scientific insufficiency but institutional and policy fragmentation. Strengthening fish health diagnostics, reforming regulatory oversight of aquaculture therapeutics, expanding farmer-centric extension services, and prioritizing field-scale validation and cost–benefit analyses are essential to reduce antibiotic dependency. Integrating scientific innovation with coordinated policy and capacity development offers Bangladesh a viable pathway toward environmentally sustainable, economically resilient, and public-health-protective aquaculture production.