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

Srinivasan Sivannan; Atukuri Vishnuvardhan; Karthikeyan Elumalai; Sivaneswari Srinivasan; Binoy Varghese Cherian; Santhana Krishnan Ramanujam; Mahalakshmi Devaraji

doi:10.1016/j.ipha.2023.06.007

Intelligent Pharmacy ›› 2023, Vol. 1 ›› Issue (4) :280 -282. DOI: 10.1016/j.ipha.2023.06.007

Case Report

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

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Abstract

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.

Keywords

Oral thrush / Azithromycin / Co-trimoxazole / White bumps

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Srinivasan Sivannan, Atukuri Vishnuvardhan, Karthikeyan Elumalai, Sivaneswari Srinivasan, Binoy Varghese Cherian, Santhana Krishnan Ramanujam, Mahalakshmi Devaraji. Azithromycin and co-trimoxazole-induced oral thrush: A case report from the perspective of pharmacy. Intelligent Pharmacy, 2023, 1 (4) : 280-282 DOI:10.1016/j.ipha.2023.06.007

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2023 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).