The antimicrobial activities of josamycin, erythromycin, and spiramycin against Rickettsia conorii and R. rickettsii were evaluated in two tests: a dye-uptake assay and a plaque assay. The MIC of josamycin was 1 microgram/ml for both species; the MICs of erythromycin and spiramycin were 4 to 8 and 16 to 32 micrograms/ml, respectively, for both species. Only josamycin may be of clinical use in treating spotted fever rickettsiosis. It may be useful in treating pregnant women and young children.