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作为第二代大环内酯类抗生素，除了抗菌作用外，阿奇霉素还具有缓解炎症反应，减少气道的黏液分泌以及抑制细菌生物被膜等特性。因此，阿奇霉素被广泛应用在非典型病原菌、部分细菌和病毒引起的感染性疾病以及囊性纤维化、慢性鼻窦炎、支气管哮喘、胃轻瘫等慢性疾病当中。阿奇霉素的广泛长期使用带来的耐药问题以及婴幼儿应用中的不良反应需要临床工作者更多的关注。该文综述阿奇霉素的作用机制及近年来临床应用进展，探讨目前缓解耐药困境的策略以及婴幼儿临床应用中的可能出现的不良反应。“,”As the second generation macrolide antibiotic, except for antibacterial effects, azithromycin can down-regulate inflammatory responses, reduce mucus secretion and inhibit bacterial biofilms.In addition to the infectious diseases caused by atypical pathogens, viral or bacterial, chronic diseases including cystic fibrosis, chronic rhinosinusitis, asthma, gastroparesis and otherdiseases can be treated with azithromycin.Clinicians should pay more attention to drug resistance and adverse reactions in infant.The article will review the progress of clinical application of azithromycin in recent years and the strategies for drug resistance and adverse effects.