Whether it is better to use azithromycin or clarithromycin for acute sinusitis needs to be decided according to the type of infecting pathogen, and the medication should be used as prescribed by the doctor. Acute sinusitis according to the different pathogens of infection, choose different anti-infective drugs. If it is caused by bacterial infection generally preferred amoxicillin clavulanate potassium, penicillin allergy, can choose azithromycin. If it is anaerobic infection, you need to choose metronidazole and other treatment. Generally need to improve the drug sensitivity, according to the results of the choice of appropriate antibiotics. Clarithromycin and azithromycin both belong to macrolide antibiotics, both can be used for infections caused by sensitive pathogens, both adverse reactions can be seen abdominal pain, nausea, vomiting, diarrhea, hepatotoxicity and so on. Azithromycin is contraindicated in people who are allergic to the product, abnormal liver function. Clarithromycin is contraindicated in pregnant women, lactating women, severe hepatic impairment, water-electrolyte disorders, people taking terfenadine treatment, certain heart disease and other groups. Azithromycin is better than clarithromycin. But the specific use of drugs also need to be judged according to the condition, should follow the doctor’s instructions for the use of drugs.