Wang, Eric J, Dolomisiewicz, Edward, Karri, Jay et al. · The Korean journal of pain · 2023 · DOI
This review examined whether antibiotics and similar antimicrobial medications might help reduce chronic pain in certain conditions, including ME/CFS. The researchers found that some of these medications appear to reduce pain in conditions where dysbiosis (imbalanced gut bacteria) or hidden infections may play a role. However, the evidence is still observational rather than definitively proving cause-and-effect relationships.
ME/CFS is explicitly discussed as a condition where antimicrobial therapies may have analgesic potential, particularly if dysbiosis or subclinical infection contribute to pain. Understanding whether antimicrobials could address pain in ME/CFS—a debilitating symptom for many patients—could inform treatment decisions. This review provides a framework for identifying which antimicrobials warrant further investigation in ME/CFS research.
This review does not establish that antimicrobials definitively cause pain reduction or that infection/dysbiosis is the primary mechanism of pain in ME/CFS. Most included studies are observational, preventing causal inference. The authors explicitly state that antimicrobials cannot become primary analgesic drugs and should only be considered when clinical justification for antimicrobial use already exists.
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
Wang, Eric J, Dolomisiewicz, Edward, Karri, Jay, Tontisirin, Nuj, & Cohen, Steven P (2023). Antimicrobial therapies for chronic pain (part 2): the prevention and treatment of chronic pain.. The Korean journal of pain. https://doi.org/10.3344/kjp.23130
BibTeX
@article{mecfsatlas-wang-2023-antimicrobial-therapies,
author = {Wang, Eric J and Dolomisiewicz, Edward and Karri, Jay and Tontisirin, Nuj and Cohen, Steven P},
title = {Antimicrobial therapies for chronic pain (part 2): the prevention and treatment of chronic pain.},
journal = {The Korean journal of pain},
year = {2023},
doi = {10.3344/kjp.23130},
note = {PubMed: 37394273},
url = {https://www.mecfsatlas.com/evidence/wang-2023-antimicrobial-therapies},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/wang-2023-antimicrobial-therapies
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