Background: Azithromycin is one of the most popular antibiotics in current clinical
practice. This medication generally considered to be safe and well-tolerated in different demographic
populations. Like any other drug, azithromycin use is not without risk and adverse effects.
In recent years, cardiovascular accidents have been announced as its major and most important side
effect. But azithromycin use can be accompanied with less recognized complications which are
significantly discomforting. In this article, we presented a neglected adverse effect of azithromycin
in medical literature which is aphthous stomatitis.
Methods: We detected three cases with this complication in our center during a one-year period. All
the accessible clinical data were recorded and PubMed database was explored to assess the relevant
Results: The patients had aphthous stomatitis within 24 hours of the first dose which was healed in
about 2 to 3 weeks. Naranjo scoring system showed a probable stage for this adverse drug reaction.
There was no such a report in our database search process.
Conclusion: It could be stated that aphthous stomatitis is an important adverse effect of azithromycin
that can affect the patient’s quality of life during therapy and in the majority of cases, it can be
neglected by healthcare practitioners.