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Azithromycin in Chronic Fatigue Syndrome (CFS), an Analysis of Clinical Data


Azithromycin in Chronic Fatigue Syndrome (CFS), an Analysis of Clinical Data

Ruud C W Vermeulen et al. J Transl Med.


Background: CFS is a clinical state with defined symptoms, but undefined cause. The patients may show a chronic state of immune activation and treatment with an antibiotic in this subgroup has been suggested.

Methods: In a retrospective study, the response of CFS patients to azithromycin, an antibiotic and immunomodulating drug, has been scored from the patients records and compared with clinical and laboratory data. Azithromycin was not the first choice therapy, but offered when the effect of counseling and L-carnitine was considered insufficient by the patient and the clinician.

Results: Of the 99 patients investigated, 58 reported a decrease in the symptoms by the use of azithromycin. These responding patients had lower levels of plasma acetylcarnitine.

Conclusion: The efficacy of azithromycin in the responsive patients could be explained by the modulating effect on a chronic primed state of the immune cells of the brain, or the activated peripheral immune system. Their lower acetylcarnitine levels may reflect a decreased antioxidant defense and/or an increased consumption of acetylcarnitine caused by oxidative stress.

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    1. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A, Schluederberg A, Jones JF, Lloyd AR, Wessely S, Gantz NM, Holmes GP, Buchwald D, Abbey S, Rest J, Levy JA, Jolson H, Peterson DL, Vercoulen JHMM. The chronic fatigue syndrome: A comprehensive approach to its definition and study. Annals of Internal Medicine. 1994;121:953–959. - PubMed
    1. Okada T, Tanaka M, Kuratsune H, Watanabe Y, Sadato N. Mechanisms underlying fatigue: A voxel-based morphometric study of chronic fatigue syndrome. BMC Neurology. 2004;4:6p. - PMC - PubMed
    1. De Lange FP, Kalkman JS, Bleijenberg G, Hagoort P, Van Der Meer JWM, Toni I. Gray matter volume reduction in the chronic fatigue syndrome. NeuroImage. 2005;26:777–781. doi: 10.1016/j.neuroimage.2005.02.037. - DOI - PubMed
    1. Bernal GM, Peterson DA. Neural stem cells as therapeutic agents for age-related brain repair. Aging Cell. 2004;3:345–351. doi: 10.1111/j.1474-9728.2004.00132.x. - DOI - PubMed
    1. Patarca-Montero R, Klimas NG, Fletcher MA. Immunotherapy of chronic fatigue syndrome: Therapeutic interventions aimed at modulating the Th1/Th2 cytokine expression balance. Journal of Chronic Fatigue Syndrome. 2001;8:3–37. doi: 10.1300/J092v08n01_02. - DOI

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