Q Fever pneumonia: are clarithromycin and moxifloxacin alternative treatments only?

Medical records of 77 patients with Q fever pneumonia that was serologically confirmed by enzyme-linked immunosorbent assay were studied to compare the clinical efficacy of doxycycline, clarithromycin, and moxifloxacin. The mean times to defervescence were 2.4 days for those receiving doxycycline, 1.9 days for those receiving clarithromycin, and 2.2 days for those receiving moxifloxacin. There were no interruptions of the regimens in any groups because of side effects, and outcome was favorable in all patients with no complications or relapses during follow-up. This efficacy of clarithromycin and moxifloxacin, together with their safety profiles, suggest that these alternative agents in the treatment of Q fever pneumonia could also be used as the first-line therapy.