Abstract: Azithromycin is a typical macrolide antibiotic with a 15-membered lactone ring and its non-antibiotic roles have been attracted increasingly great attention in recent years. The purpose of our present review is to summary the various non-antibiotic effects of azithromycin, including activities of anti-inflammation, immunomodulation, biofilm damage, regulation of airway mucus, change of macrophage phenotype and regulation of liquid electrolyte among airway surface, and simultaneously, its beneficial effects of long-term clinical application in treatment of lung disease with chronic infection with low dose as well as its nebulization efficiency.

Key words: Key words: azithromycin, non-antibiotic effects, atomization management