Flowchart of trial design. * According to the Dutch guideline Q fever fatigue syndrome . Including questionnaires: general questionnaire, CIS, SIP total score. ** General questionnaire, PARS, SES28, IMQ, CBRSQ, JFCS, CAL, and SCL90. # Questionnaires used for mediation analysis: PARS, SES28, IMQ, CBRSQ, and CIS. ¥ Exclusion criteria: pregnancy; serious adverse events; AST/ALT > 5 times normal value; AF > 3 times normal value; > 10 days use of quinolon, co-trimoxazol, macroliden or tetracycline; or discontinuation of study medication > 7 consecutive days. ^ CIS, PARS, IMQ, JFCS, SIP, SES28, CBRSQ, and SCL90. Abbreviations: CIS = Checklist Individual Strength, SIP = Sickness Impact Profile, ECCF = Expert Centre for Chronic Fatigue, PARS = Physical Activity Rating, SES28 = Self Efficacy Scale, IMQ = Symptom focusing of the illness Management Questionnaire, CBRSQ = Cognitive and Behavioral Responses to Symptoms Questionnaire, JFCS = Jacobson Fatigue Catastrophising Scale, CAL = Causal Attribution List, SCL90 = Symptom Checklist 90, CBT = cognitive behavioral therapy, AST = aspartate aminotransferase, ALT = alanine aminotransferase, AF = alkaline phosphatase.