Can Azithromycin Cause Yeast Infections?
Our pharmacist answers the latest question regarding how the antibiotic azithromycin can cause yeast infections.
Hello. I was prescribed Azithromycin (Zpack) Friday morning for a sinus infection. I took my first dose Friday. My second dose was yesterday evening. Now am experiencing slight vaginal discomfort, itching, and burning on the exterior when urinating. Is this normal?
Nov 01, 2022- Azithromycin can cause yeast infections by killing normal protective bacteria, allowing yeast to overgrow, and this happens in about 1-3% of people taking the antibiotic.
- Report any symptoms to your doctor so they can determine the cause and provide appropriate treatment if needed.
- Probiotic supplements taken during antibiotic therapy may help prevent antibiotic-associated yeast infections by restoring normal bacterial flora.
Answer
Anytime a systemic antibiotic therapy is given, such as azithromycin, there is a chance that the normal bacterial flora is altered. A change in our normal flora can cause a range of adverse reactions including gastrointestinal discomfort, urinary tract infections, and yeast infections.
Antibiotics Can Sometimes Cause Yeast Infections
The symptoms you mention in your question sound similar to the symptoms experienced by those with a yeast infection or a urinary tract infection, and, unfortunately, yeast infections are fairly common in those that take azithromycin.
The antibacterial activity of the drug eliminates the 'good', normal bacterial flora in the vagina. This can lead to an overgrowth of the Candida species, a pathogenic yeast that is most commonly associated with yeast infections.
Your symptoms aren't considered 'normal' in terms of everyone experiencing them but are 'normal' in terms of being a well-known side effect of antibiotic therapy.
Current data suggests that between 1% and 3% of those on azithromycin therapy get yeast infections (i.e. antibiotic-associated yeast infections) so it certainly is not uncommon. One such study states the following:
In this pilot study, the use of short courses of oral antibiotics seems to increase prevalence of asymptomatic vaginal Candida colonization and incidence of symptomatic VVC [Vulvovaginal Candidiasis]. Larger cohort studies are needed to confirm these findings.
It is important that you report your symptoms to your doctor so they can evaluate you and determine the cause. You may need to be treated separately for the symptoms you are experiencing.
If you are diagnosed and treated for a yeast infection, you could try to take a probiotic supplement when you are prescribed antibiotics.
They may be beneficial in preventing antibiotic-associated yeast infections in the future as they are thought to replace some of the normal bacterial flora and prevent opportunistic pathogenic organisms such as Candida.
Final Words
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References & sources
- Zithromax Prescribing Information — AccessFDA
- Effects of erythromycin, clarithromycin, roxithromycin and azithromycin on murine gut colonization by Candida albicans — PubMed
- Effect of antibiotics on vulvovaginal candidiasis: a MetroNet study — PubMed
- Epidemiology, diagnosis and treatment of systemic Candida infection in surgical patients under intensive care — PubMed
Glossary — Terms in This Answer
- Systemic antibiotic therapy
- Antibiotics taken by mouth or injection that travel through the bloodstream to treat infections throughout the entire body.
- Bacterial flora
- The community of naturally occurring bacteria that live in and on your body, especially in your digestive tract and other areas.
- Azithromycin
- A commonly prescribed antibiotic medication used to treat bacterial infections.
- Gastrointestinal discomfort
- Stomach and digestive tract problems such as nausea, cramping, or diarrhea.
- Candida
- A type of yeast that normally exists in small amounts on the body but can overgrow and cause infections when conditions are right.
- Pathogenic
- Capable of causing disease or infection.
- Probiotic supplement
- A product containing beneficial bacteria meant to restore healthy bacterial balance in your gut and body.
- Opportunistic pathogenic organisms
- Harmful microbes that take advantage of a weakened or unbalanced system to cause infection.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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