Azithromycin and co-trimoxazole-induced oral thrush: A case report from the perspective of pharmacy

• Published in: Intelligent Pharmacy Vol. 1; no. 4; pp. 280 - 282
• Main Authors: Sivannan, Srinivasan, Vishnuvardhan, Atukuri, Elumalai, Karthikeyan, Srinivasan, Sivaneswari, Cherian, Binoy Varghese, Ramanujam, Santhana Krishnan, Devaraji, Mahalakshmi
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.12.2023
• Subjects: Azithromycin; Co-trimoxazole; Oral thrush; White bumps; White bumps; Oral thrush; Co-trimoxazole; Azithromycin
• ISSN: 2949-866X; 2949-866X
• DOI: 10.1016/j.ipha.2023.06.007

Oral thrush, also known as candidiasis, is one of the most common parasitic infections of the human mouth. A 35-year-old female patient complaining of breathlessness, cough, and fever. She was prescribed azithromycin 500 ​mg po (per os; by mouth, orally), co-trimoxazole 160 ​mg ​+ ​800 ​mg po, and Paracetamol 500 ​mg po t.d.s. After 10 days, she visited a tertiary care hospital complaining of severe oral thrush, itching, white bumps over her cheeks and tongue, and difficulty swallowing. She stopped taking solid food due to severe pain. Her laboratory tests revealed that her haemoglobin was -6.8 ​g/dl (12–16 ​g/dl) and her erythrocyte sedimentation rate was 45 ​mm/h. Due to a side effect of the antibiotics, she had very bad mouth thrush. To the best of our knowledge, this is the first reported case of oral candida inducing a patient after treatment with the anti-candida drugs, and it suggests that this side effect should be taken into account when prescribing these antibiotics.