Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 7 4 2020 02 03 118 119 EN Fatma Hammami Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Salma Fourati Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Makram Koubaa Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Fatma Smaoui Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Khaoula Rekik Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Chakib Marrakchi Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia Mounir Ben Jemaa Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia 2019 10 23 2019 11 03 Macrolide antibiotics are commonly prescribed and are usually well tolerated. Azithromycin-related anemia and thrombocytopenia has not been reported previously. Here, we present the case of a 63-year-old man with bicytopenia following azithromycin treatment for ocular toxoplasmosis. He developed both thrombocytopenia and anemia after less than 7 days of treatment. Pyrimethamine, known for its hematologic side effects, was stopped on admission. However, the platelets drop continued to worsen. Then, azithromycin has been incriminated. All his symptoms and laboratory abnormalities were recovered within 7 days after the discontinuation of azithromycin treatment. Physicians must be aware of azithromycin-induced bicytopenia because its early detection can decrease the severity of these side effects. https://jpc.tums.ac.ir/index.php/jpc/article/view/291 https://jpc.tums.ac.ir/index.php/jpc/article/download/291/216