Columnaris can external and internal bacterial infection with bacterial fin rot that usually external for most other bacterial infections I treat with medication in food it very effective at treating external bacterial infections and internal bacterial when added food theirs a couple of antibiotic treatment such as kanaplex and maracyn2 that are adsorbed thought the skin and gills so they are good antibiotics for when fish aren't eating most antibiotic need to be added to food to treat internal bacterial infections