Question

Please could you provide some guidance on the use of antibiotics if you have ME/CFS. I’ve read about people on internet discussion forums who have been prescribed antibiotics as a treatment. On the other hand, some people say that antibiotics are best avoided if you have ME/CFS.

Answer

There is no evidence to indicate that antibiotics are an effective form of treatment for ME/CFS. Having said that, there is some evidence that suggests because antibiotics can also have an effect on immune system function, they may be of use in the treatment of conditions that involve immune system dysfunction. One example here is the way in which Tetracycline antibiotics have been investigated as a possible form of treatment for Rheumatoid Arthritis. However, no such research has been carried out in people with ME/CFS.

In regard to using antibiotics when someone with ME/CFS has an infection, these are the points that we suggest are considered:

• Provided they are used properly, antibiotics are normally a very effective way of dealing with bacterial infections.
• As infections are an important cause of relapse in ME/CFS, the prompt use of an antibiotic would be entirely appropriate if the infection is likely to respond to an antibiotic,
• Some people with ME/CFS are allergic or sensitive to specific antibiotics (e.g., penicillin). Where this occurs that particular antibiotic is clearly contra-indicated.
• There is no evidence to indicate that people with ME/CFS are allergic or more sensitive to any particular type of antibiotic, or group of antibiotics. So the most effective antibiotic should normally be used – according to the type and severity of the infection.
• There is no antibiotic of preference for people with ME/CFS.
• The fluoroquinolone group of antibiotics are best avoided unless really necessary: MHRA Precautions for Fluoroquinolone | March 2019
• If an antibiotic is prescribed you should continue to take it until the course has finished.
• If you are experiencing side-effects, contact your pharmacist or GP.