Symptomatic syndrome of inappropriate antidiuretic hormone secretion associated with azithromycin.
OBJECTIVE
To report a case of symptomatic syndrome of inappropriate antidiuretic hormone (SIADH) secretion associated with azithromycin and review the literature related to this adverse drug reaction.


METHODS
Review articles identified by a computerized (MEDLINE) (1966-April 1996) and manual (Index Medicus) search.


RESULTS
Azithromycin is a well-tolerated broad-spectrum macrolide antibiotic. We report a symptomatic case of SIADH secretion associated with azithromycin. The patient received two doses of azithromycin before the development of sudden mental status changes associated with severe hyponatremia. All other potential causes were ruled out. No previous reports exist in the literature.


CONCLUSIONS
Azithromycin may be associated with symptomatic SIADH secretion. Awareness and attention are required if patients develop mental status changes or hyponatremia while receiving azithromycin so that appropriate diagnostic and therapeutic actions can be implemented.
Cadle
R M
RM
Pharmacy Service (119), Veterans Affairs Medical Center, Houston, TX 77030, USA.
Darouiche
R O
RO
Ashton
C M
CM
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017963:Azithromycin / Q000009:adverse effects*; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged
D000900:Anti-Bacterial Agents; D017963:Azithromycin