My first round of CFS was diagnosed as antibiotic resistant walking pneumomia. This was back in the early 1970’s when many MDs thought that it was caused by a virus and thus when antibiotics failed, there was nothing to do but de-stress and wait and pray — which I did. Subsequent round had the one effective family of antibiotics (tetracycline) against mycoplasma pneumoniae(MP) as part of the treatment. MP produces neurologic issues . The fastest recovery was the last time where tetracycline had a slow impact, but the user of appropriate herbs and probiotics resulted in a much faster recovery.
Recently there has been wave after wave of stressful issues hitting me for the last 6+ weeks and my classic “stress cough” has re-appear. This means that the mycoplasma pneumoniae(MP) has prospered from the stress. Needless to say, I have been very aggressive in reducing/eliminating stress — this means that I will become rude or upsetting to others if need be. I cannot afford to “put up with” or “hope for the best”. Stress must be eliminated.
Time for a review of treatment options
I have been on and off tetracyclines so much over the years that the MP is likely resistant by now, the general level of resistance may be about 25%. The last time with CFS, there was no major herx or other clear signs of impact. Reading about mycoplasma, it become clear that treatment is not trivial because it lacks cell walls and can mimic normal cells. The following appear to have potential.
- azithromycin, erythromycin and gamma globulin combined aspirin
- There are some chinese herbs ( Radix Isatidis, Radix Angelicae Dahuricae – Bai Zhi (白芷)., Cortex Phellodendri – Huáng bǎi (黄栢, Radix et Rhizoma Rhei – Rhubarb, Fructus Kochiae – Di Fu Zi, 地肤子 and Herba Houttuyniae – Yu Xing Cao) which may be effective 
- aspirin 
Reducing stress – specifically the physiological response to stress which I suspect encourages MP growth:
- Ashwagandha (and appears to positively impact pneumonia )
Recently, I have been using Align, Culturelle and L.Reuteri with a significant lessening of symptoms after 5 days. Keeping with the model that the active infection alters gut bacteria, then by counter balancing with probiotics may weaken the infection. It’s rest and taking it easy until MP symptoms are gone.