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Severe odynophagia in a patient developing after azithromycin intake: a case report
Umit Akyuz1, Yusuf Erzin, Fevzi Firat Yalniz
1Department of Gastroenterology, Yeditepe University Medical Faculty, Devlet Yolu Cad 102-104 34752 Kozyatagi, Istanbul, Turkey. dryusuferzin@yahoo.com.
Cases Journal
|March 9, 2010
Summary
This case report details the first instance of an esophageal ulcer caused by the antibiotic azithromycin. Physicians should advise patients to take oral medications with ample water to prevent such drug-induced esophageal ulcers.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Drug-induced esophageal ulcers are a known complication, often presenting with pain and dysphagia.
- Azithromycin is frequently prescribed for respiratory infections and otitis media.
- This is the first reported case of an esophageal ulcer linked to azithromycin use.
Purpose of the Study:
- To report a novel case of azithromycin-induced esophageal ulceration.
- To highlight the importance of medication administration guidance.
Main Methods:
- A 61-year-old male presented with odynophagia and retrosternal pain after a three-day course of azithromycin.
- Upper endoscopy revealed a midesophageal ulcer.
- Biopsies excluded neoplasia and infection, showing acute inflammation.
Main Results:
- The patient experienced symptom resolution within two weeks with conservative management (liquid diet, sucralfate, PPI).
- Follow-up endoscopy confirmed complete healing of the esophageal ulcer.
- No underlying neoplastic or infectious etiology was identified.
Conclusions:
- Azithromycin can induce esophageal ulceration, a rare but significant adverse effect.
- Educating patients on proper medication intake, such as drinking sufficient water, may prevent these ulcers.
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