van Roeden SE, et al. - Researchers sought for evidence on the effectiveness of first-line treatment for chronic Q fever, tetracyclines (TET) plus hydroxychloroquine (HCQ), and potential alternatives. As per findings, treatment of chronic Q fever with TET plus quinolones (QNL) seemed to be a safe alternative for TET plus HCQ, for example, if TET plus HCQ cannot be tolerated due to side effects. No superiority of treatment with TET plus QNL plus HCQ to treatment with TET plus HCQ was identified, although this could be caused by confounding by indication. They recommended avoiding treatment with TET or QNL monotherapy. Switches were frequently observed due to subjective, insufficient clinical response.