Erythromycin is commonly used for the empirical treatment of community-acquired
pneumonia, but there is some concern about its usefulness when
Q fever is suspected because of in-vitro studies showing a lack of efficacy against Coxiella burnetii. This study was undertaken to assess the clinical value of the
antibiotic in this setting. Nineteen patients with
Q fever pneumonia treated with a variety of
antibiotics considered ineffective against C. burnetii, were reviewed. Eleven patients who received
erythromycin had a rapid clinical improvement and each became afebrile by the fourth day of treatment. However, only two of eight patients who received other
antibiotics improved (both of them had been treated with
beta-lactams). Both groups were comparable regarding to age and previous duration and severity of disease. Those patients who did not respond to other
antibiotics improved promptly after
erythromycin was started. This study suggests that
erythromycin is an adequate treatment for
Q fever pneumonia.