A RARE CASE OF CUTANEOUS ADVERSE DRUG REACTION OF AZITHROMYCIN: A CASE REPORT

Azithromycin, a macrolide antibiotic, an azalide derivative of erythromycin, is a Schedule H drug that can be procured from pharmacies in India only with a prescription. Despite the strict regulations, it is commonly available as an over-the-counter (OTC) medication in most pharmacies in India. A 33-year-old male had complaints of fever and sore throat, for which he self-administered tablet Azithromycin 500 mg once daily for three days. Two days after the last dose, he noticed the development of an itchy, erythematous rash. He was diagnosed with acute generalised exanthematous pustulosis (AGEP). Azithromycin was discontinued immediately, and he was treated in the ICU with corticosteroids and antihistamines. Acute Generalised Exanthematous Pustulosis (AGEP) is a rare and self-limiting Severe Cutaneous Adverse Reaction (SCAR) induced by medications. It presents with the rapid appearance of numerous non follicular, sterile pustules on a widespread erythematous base, often accompanied by fever and neutrophilic leukocytosis.This case highlights the potential for azithromycin, a commonly used and generally well-tolerated antibiotic, to induce rare but significant cutaneous reactions such as AGEP. Clinicians should remain vigilant when prescribing antibiotics, especially in patients who present with new-onset rashes during or after therapy.