Question and Answer Forum

Are there antibiotics that CFS patients should avoid?

By David S. Bell, MD, FAAP

Published in Lyndonville News, May 1999

Question: I have CFS and was recently prescribed ciprofloxacin for prostatitis for which I suffered very bad side effects, mostly CNS (Central Nervous System). Are there any antibiotics that CFS patients should avoid?

Answer: The question of antibiotics in CFS is a complex and interesting question. It traverses the issues of bacterial causes for CFS (Lyme, Chlamidiae, Mycoplasma, etc) and the issue of decreased immunological responses leading to increased infections such as sinusitis and bronchitis.

In general, if there is a straightforward infection, it should be treated in CFS patients, the same as in those without CFS. Very strong antibiotics should be avoided to prevent emerging resistance among bacteria, a general statement that is as true in CFS as in any other condition.

Some antibiotics may not be tolerated as well as others in people with CFS. Work by some researchers has hinted that this may be due to a Herxheimer reaction. This is a response where the destroyed bacteria are causing a reaction by reacting with antibodies and other parts of the immune response. However, I favor another reason for the observation that some antibiotics may be harsh for persons with CFS and that is because they have some stimulant properties. The fluoroquinolones, for example, (Cipro, Floxin, others) may cause central nervous system stimulation, and most persons with CFS do not do well with stimulants (coffee for example). This would not be an allergic reaction, it is more of a predisposition to a specific set of side effects in the person with CFS. Having said this, I still use drugs of this class when necessary.

At present I am more likely to treat with antibiotics than I was ten years ago. Children and some adults often present with CFS with a series of upper respiratory infections, such as sinusitis and bronchitis. It is likely that a relatively minor immunological deficit will be found to explain this. Minor in that these infections do not progress to serious or life threatening infections.

My favorite antibiotic in CFS remains doxycycline. Fifteen years ago we treated several hundred persons with it and I had the clinical suspicion that persons with CFS were improved by it. I do not know why that would be. Doxycycline is known to have an effect in rheumatoid arthritis - maybe it’s a non-specific effect. Perhaps its because of mycoplasma or chlamydiae. But whatever the reason, it remains among the first to be tried in patients over the age of ten (it can cause teeth staining in younger children). I do not believe that the effect of doxycycline is all that great - it does not cure CFS, and I doubt it alters the long term course, although there is an active argument concerning this within our own office.

Return to the Q & A Page

Return to the Lyndonville News Archive

Return to the CFS Page

Home	News	Forum	Contribute	Store	Articles	Links	Help
The Pediatric Network website and forum are run by Mary Robinson and Rebecca Moore. When you follow links on our site to Amazon.com and make purchases, a portion of the sales cost supports our work. Visit our store for shopping suggestions:  gifts for kids or parents, tools for adapting activities, medical and special education books, coping strategies, and more.

Disclaimer: The views in this website and forum are the feelings and opinions of the individual authors and do not necessarily reflect all of the current theories that are being explored and published. Ask your doctor or other health care provider about all medical information that you consider applying to your situation, including the information you read in our website and forum. We take no responsibility for the decisions you or your family members make about medical care. It is up to you to verify that the information you read is correct and applies to your unique situation.