Azithromycin injection, an antibiotic used to treat bacterial infections, has a high number of intravenous infusion reactions, accounting for 12% of patients who use it. The main reactions are irritation of the endovascular lining producing very pronounced endovascular inflammation, resulting in pain, local erythematous vascular thrombosis, and thrombotic superficial phlebitis. This condition can be significantly improved by reducing the titration rate according to the literature. If endovascular inflammation has already occurred, topical or physical therapy can be used to promote the absorption of the inflammation, or topical application of Xylitol can be used to reduce pain and accelerate the absorption of the inflammation. If the symptoms are severe, non-steroidal anti-inflammatory drugs such as ibuprofen or diclofenac sodium can be used orally to control inflammation and reduce pain as well.