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Azithromycin in Chronic Fatigue Syndrome (CFS), an analysis of clinical data

SOC

Senior Member
Messages
7,849
In the CFS and Pain Research Center Amsterdam, patients are diagnosed with CFS according to the Fukuda criteria [1].
The response rate of 59% in this retrospective open study is not necessarily indicative for the effect rate in prospective blinded studies
Wow, besides the information about the effectiveness of azithromycin, which could do a lot for our quality of life, this paper actually pays attention to responsible research such as clearly defining your research cohort in the abstract so readers know the applicability of the research, and acknowledging the limitations of your results. :thumbsup: Psychoquacks could learn something from this... if they were willing to learn about doing responsible research.

Isn't this surprising coming out of a CFS research center in the Netherlands? o_O Or am I wrong about the state of CFS research and treatment in the Netherlands?
 

A.B.

Senior Member
Messages
3,780
Isn't this surprising coming out of a CFS research center in the Netherlands? o_O Or am I wrong about the state of CFS research and treatment in the Netherlands?

I'm more surprised that this hasn't been researched further. A proper clinical trial is justified. These results don't seem to be far behind the Rituximab open label study and azithromycin is much cheaper.
 
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SOC

Senior Member
Messages
7,849
I'm more surprised that this hasn't been researched further. A proper clinical trial is justified. These results don't seem to be far behind the Rituximab open label study and azithromycin is much cheaper.
Nothing surprises me regarding the inadequacy of research related to ME. :rolleyes:

I agree, though, that this warrants prompt further research. The research and the treatment should be relatively cheap and easy. Maybe we need to offer to crowdfund a study for some reputable ME researcher. :p
 

Denise

Senior Member
Messages
1,095
Isn't this surprising coming out of a CFS research center in the Netherlands? o_O Or am I wrong about the state of CFS research and treatment in the Netherlands?

Vermuelen has done some interesting work.
These are links to a few things:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(01)05419-8/abstract

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964609/

http://www.translational-medicine.com/content/12/1/20


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1621077/
 

Daffodil

Senior Member
Messages
5,875
Has anyone on the forum used azithromycin? and if so, did it help?
a lot of people have used it as part of a lyme disease treatment protocol. i have used it. it may have helped a little but i change medication pretty often so i cannot be sure. the only thing that helped A LOT was IV Rocephin...but that is a very powerful, wide spectrum antibiotic that one cannot take indefinitely.
 

Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
This is a very curious study. and I'm not to keen on this sort of restrospective data mining. I also can't work out what their rationale was for prescribing azithromycin in the first place although why they think it may be helping is possibly prescient (and nothing to do with its antiobiotic activity) :

If CFS is caused by a primed state of glia-cells in the brain [46] in a subgroup of patients, these cells would produce interleukin-1β at an increased rate as response to minor stimulation by stress or infection. The result is a chronic and fluctuating state of sickness that is not fully explained by the presence of an active and detectable disease state. Then it is likely that the immunomodulating drug azithromycin could improve the severity of CFS symptoms.

Interestingly the immune modulating effects of azithromycin appear to attenuate TLR4 signalling which is the pathway by which many peripheral and psychological stressors activate microglia :

Azithromycin distinctively modulates classical activation of human monocytes in vitro

CONCLUSIONS AND IMPLICATIONS

Azithromycin modulated classical activation of human monocytes by inhibition of TLR4-mediated signalling and possible
effects on lysosomal function, and generated a mediator expression profile that differs from that of monocyte/macrophage phenotypes so far described.

http://onlinelibrary.wiley.com/doi/10.1111/j.1476-5381.2011.01576.x/pdf

The immune modulating effects of various antibiotics; including their effects on the brain are intriguing :

Immunomodulatory Properties of Antibiotics

http://www.medicinabiomolecular.com.br/biblioteca/pdfs/Biomolecular/mb-0467.pdf
 

medfeb

Senior Member
Messages
491
Has anyone on the forum used azithromycin? and if so, did it help?
My son was on a combination of Azithromycin and Doxycycline because of a positive Lyme. Very positive response and very quickly. He was able to walk a few miles at a time and he read a number of books, planned his wedding, went to coffee shops, etc. But it only lasted a few months. He was never able to regain the functional improvement, in spite of later azithro, rocephin and some other lyme treatments over almost a year.
 

drob31

Senior Member
Messages
1,487
My son was on a combination of Azithromycin and Doxycycline because of a positive Lyme. Very positive response and very quickly. He was able to walk a few miles at a time and he read a number of books, planned his wedding, went to coffee shops, etc. But it only lasted a few months. He was never able to regain the functional improvement, in spite of later azithro, rocephin and some other lyme treatments over almost a year.

This kind of sounds like the David Berg theory. You experience initial improvements, then hypercoagulation increases, trapping more lyme and other pathogens, and they continue to cause hypercoguability which prevents you from reaching the infection. He advocates using heparin to disolve fibrin and then ABX.
 
Messages
15,786
My son was on a combination of Azithromycin and Doxycycline because of a positive Lyme. Very positive response and very quickly. He was able to walk a few miles at a time and he read a number of books, planned his wedding, went to coffee shops, etc. But it only lasted a few months. He was never able to regain the functional improvement, in spite of later azithro, rocephin and some other lyme treatments over almost a year.
How long was he on the initial course?
 

Overstressed

Senior Member
Messages
406
Location
Belgium
Everytime I take Azithromycin I feel much better. Currently I'm taking Minocycline because I had an outbreak of itching scalp with a lot of lumps. I was walking in the forest and don't know if that was the cause of it. The day after, I started having these lumps and swollen lymphs in my neck.

As for Minocycline, it is remarkable how flat my stomach now is, and how well my food is digested. As a side note: there are scientific reports that say that Minocycline helps with HIV infection. I don't know the details, but it seems to work on the latent infected cells, preventing them to reactivate, and replicate.

Note, I really don't know what illness I have...
 

medfeb

Senior Member
Messages
491
How long was he on the initial course?
I believe he was on the initial course for a few months. It was when he went off that he started to decline. But in spite of going back on the same regimen fairly quickly, he never recovered to that previous level of functioning. No way to know whether he would have relapsed even if he had stayed on it or not. I've heard anecdotal comments from other patients that they had the same experience of initial improvement followed by relapse.
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,089
Location
australia (brisbane)
What dose and frequency do most use of azithromycin ?

I have read from 1 to 2 days a week to daily. With doses between 250 to 1000mg.

I know it has a long half life of approx 3 days. I just wonder if 1000mg once a week would be effective for chronic infections, probably with doxycycline or bactrim .
 

soxfan

Senior Member
Messages
995
Location
North Carolina
I was on it as well....many times over the past nine years. I don't believe it really had any impact on how I felt. It did make me much more fatigued so I usually took my dose at night.

At one point I was taking 500 mg daily and I have also taken 250mg daily due to a long half life. The only thing that ever helped me was IV Rocephin which I was on for six months. I would have continued on it since I was having a great response but suffered gallbladder issues. Within months after discontinuing it I started to go backwards.

I tried IV again a year later and had no improvement at all...

I also have no idea what is truly wrong with me either. The doctors can't seem to figure it out.