Hi, A bloody nose or epistaxis as it is called in medical terminology can be caused by a numbers of different factors. The most common cause being digital trauma (medical way of saying nose picking). In your husbands case it is likely a result of dried irritated mucosa in his nasal cavities. Often when a person has a upper respiratory infection like a cold or viral or bacterial infection of sinuses and airway. The mucosal surface of the skin becomes dried out and irritated which makes nose bleeds occur. Medications used to treat symptoms like your husband s often cause the mucosa to dry out as well and become irritated making one prone to nose bleeds as well. Azithromycin is not commonly associated with nose bleeds but could be a factor in your husband s case but other medications like expectorants or decongestion medications are more often associated with nose bleeds. I often encourage my patients to use are humidifiers and petroleum jelly / skin moisturizers to keep their mucosa moist and to prevent dry skin leading to cracking and irritation. There are other potential causes of these symptoms but I have discussed the most likely causes. I would recommend following up with your husband s doctor for further evaluation and any further treatment. If your husband continues to experience concerning symptoms seek urgent medical assistance right away. Hopefully this has helped to answer your question. I appreciate the opportunity to answer your question. Be well. Sincerely, Dr. Marcucci