Pre clinical work in vivo and in vitro have suggested that azithromycin has a low potential for significant drug interactions. Clinical studies conducted thus far have generated results in accordance with the preclinical science [6]. Direct comparisons with the most modern macrolides have been published and evidence suggests that azithromycin is likely to be associated with fewer significant drug interactions. However, as a final point, I wish to point out that proof of an absolute negative is not possible and therefore in any patient, on multiple medication with adverse findings, a drug interaction should be considered as part of the differential diagnosis.