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Several papers have reported on the development of antibiotic resistance and implications for human medicine but fewer deal with environmental impacts of antibiotic use. Marine sea cage aquaculture in SE Asia is often established close to coral reef ecosystems. Large amounts of antibiotics are used in the cultivation of fish and lobster and hence released directly into the environment. This study investigates the antibiotic practices in sea cage farms producing fish and spiny lobster in Vietnam, mainly for the domestic market. There are approximately 3500 sea cage farms in Vietnam and we performed semi-structured interviews with 109 sea cage farmers asking them if they use antibiotics and if so; what sort/when/how often/how much. We found that the Vietnamese cage farmers are using antibiotics in an unstructured way, which seems to have little or no effect on the survival of the stock, or profit of the farm. The fact that the farmers live at their farm and use the sea next to the cages both for fishing and collecting filter-feeding bivalves for direct consumption, as well as a toilet, poses an additional risk for the spreading of human antibiotic resistant pathogens. Thirteen different antibiotics were found in the study. Eighty-two percentage of the lobster farmers and 28% of the fishfarmers used antibiotics. The average amounts used were over 5 kg per produced ton of lobster and about 0.6 kg per ton of fish, which is much higher than in other studies. Several antibiotic substances listed as “critical” and “highly important” for human medicine by WHO were used prophylactically and routinely with little control and enforcement of regulations. We tested and detected antibiotic resistance to Tetracycline, Vancomycin and Rifampicin in the coral associated bacteria Bacillus niabensis as far as 660 m from fish farms with resistance decreasing with distance from the cage farms. The antibiotics are likely to have negative effects on the coral-symbiont relationship adding further risks to an already stressed environment. [ABSTRACT FROM AUTHOR]