Background: In 2015, the World Health Organization (WHO) urged member states to develop national action plans to address the growing threat of antimicrobial resistance in humans. A key recommendation was to reduce the use of antibiotics in livestock, poultry, and aquaculture sectors where overuse contributes significantly to the emergence of resistant pathogens. In aquaculture, the prophylactic and therapeutic use of antibiotics has led to the emergence of antibiotic-resistant bacterial strains that can enter the food chain and pose serious risks to human health.
Materials and Methods: This narrative review synthesizes findings from original and peer-reviewed articles published between 2010 and 2025, retrieved from reputable scientific databases: PubMed, Scopus, Web of Science, and Google Scholar. Sources were selected based on their relevance to immunomodulatory strategies as alternatives to antibiotics in aquaculture and public health. Particular emphasis was placed on studies investigating the molecular mechanisms and functional outcomes of Spirulina platensis bioactive compounds, especially their immunostimulatory and antimicrobial effects in fish and human health contexts.
Results: S. platensis, a filamentous cyanobacterium rich in protein, carbohydrates, essential fatty acids, vitamins, pigments (chlorophyll, beta-carotene, phycocyanin), phenolic compounds, and antimicrobial peptides, has demonstrated positive effects on fish growth, immunity, hematobiochemical parameters, and disease resistance. Its natural antimicrobial and immunostimulatory properties suggest that Spirulina can serve as a sustainable alternative to antibiotics in aquaculture. Moreover, recent studies have highlighted its beneficial effects in humans, including modulation of gut microbiota, enhancement of immune function, antioxidant and anti-inflammatory activity, and potential roles in weight management and metabolic regulation.
Conclusion: S. platensis holds promise as a natural, eco-friendly solution to antibiotic overuse in aquaculture. Its integration into fish diets may support global efforts to neutralize antimicrobial resistance and promote safer food production systems. Additionally, its health-promoting effects in humans position Spirulina as a valuable functional food with potential applications in preventive nutrition and public health.