Three patients with fish tank granuloma of the hand and forearm are re
ported, Each patient was treated with antimicrobial regimes which have
rarely or never been previously used in this condition, Two patients
responded web to treatment, one who received ciprofloxacin plus clarit
hromycin and another who was given clarithromycin plus ethambutol. The
third patient received six different antimicrobial regimes before res
ponding to a combination of rifabutin and ciprofloxacin. Our experienc
e suggests that there now exist a number of effective alternatives to
antimicrobials which have been traditionally used in the treatment of
cutaneous Mycobacterium marinum infection.