Miwa, Kunihisa · eNeurologicalSci · 2025 · DOI
This small study looked at whether a common antibiotic called minocycline might help people with ME/CFS, including those with long COVID. Fifty-five patients took minocycline for about 6 weeks, and 80% of those who completed the treatment reported meaningful improvements in their symptoms like fatigue, brain fog, and sleep problems. The treatment worked best for people early in their illness (within 6 months of symptom onset).
This is one of the first studies examining minocycline for ME/CFS treatment, and it shows promising results particularly for early-stage disease and long COVID—conditions with limited evidence-based therapeutic options. Understanding whether early antibiotic intervention might help ME/CFS patients could significantly change clinical management approaches during the critical early disease period.
This observational study cannot prove minocycline causes symptom improvement due to lack of a control group, placebo effect cannot be excluded, and the small sample size and short follow-up period limit generalizability. The study does not establish optimal dosing, long-term safety, mechanism of action, or whether benefits persist after treatment ends.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Miwa, Kunihisa (2025). Oral minocycline therapy as first-line treatment in patients with Myalgic encephalomyelitis and long COVID: A pilot study.. eNeurologicalSci. https://doi.org/10.1016/j.ensci.2024.100537
BibTeX
@article{mecfsatlas-miwa-2025-oral-minocycline,
author = {Miwa, Kunihisa},
title = {Oral minocycline therapy as first-line treatment in patients with Myalgic encephalomyelitis and long COVID: A pilot study.},
journal = {eNeurologicalSci},
year = {2025},
doi = {10.1016/j.ensci.2024.100537},
note = {PubMed: 39720104},
url = {https://www.mecfsatlas.com/evidence/miwa-2025-oral-minocycline},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/miwa-2025-oral-minocycline
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