Azithromycin is a clinically common antibiotic, a semi-synthetic pentadecameric macrolide broad-spectrum antibiotic, suitable for whistling tract, skin and soft tissue infections caused by sensitive bacteria, especially for the treatment of mycoplasma chlamydia infection. Its common side effects such as gastrointestinal reactions, skin pruritus, dizziness, etc. will be frequently encountered in the clinic, but for the rare pairing-induced adverse reactions are rarely noticed by medical personnel, but once they occur is a fatal consequence. Macrolides are associated with serious adverse reactions such as prolonged QT interval, ventricular fibrillation, and tip-twisting ventricular tachycardia. The risk of these arrhythmias increases when patients develop electrolyte disturbances such as hypokalemia and hypomagnesemia. When azithromycin is combined with Glycyrrhiza glabra tablets, the risk of malignant arrhythmias increases because the main ingredient of Glycyrrhiza glabra tablets is glycyrrhizin, which is hydrolyzed in the body to glycyrrhizin hypoglycyrrhizic acid, which has a salicocorticoid-like effect on the distal renal tubules causing potassium loss and hypokalemia. Therefore, when azithromycin and compound glycyrrhiza tablets are combined, patients need to be observed for ECG QT interval and appropriate potassium supplementation to prevent adverse consequences. Stabilizing atheroma drugs such as simvastatin are CYP3A4 enzyme substrates and metabolized by hepatic drug enzyme CYP3A4, while macrolides such as azithromycin are CYP3A4 enzyme inhibitors, and the interaction between them can lead to a significant increase in statin blood concentration and cause acute hepatic necrosis. When azithromycin is combined with statins such as simvastatin, the dose of statins used needs to be on the small side, and the daily dose of simvastatin is controlled to 20mg or less. For patients with myasthenia gravis, in addition to quinolones that can cause myasthenia gravis, macrolide antibiotics such as azithromycin can cause myasthenia gravis symptoms to worsen and even induce critical conditions such as increased limb weakness, chest tightness, difficulty with inspiration, and difficulty swallowing. Therefore, these drugs are used with caution or contraindicated in the treatment of patients with myasthenia gravis. The common drug azithromycin in the use of so many other places that need special attention, and are ignored, these are in the clinical work of the relevant cases to attract attention, the clinical emergence of these lessons also gives us a good reminder in the future work.