Cephalosporin and azithromycin are two products, generally in clinical treatment, cephalosporin is chosen more often because it has less adverse reactions; azithromycin has more adverse reactions compared to cephalosporin. In terms of antibacterial effect, the antibacterial effect of azithromycin is better. For the use of antibiotics in children, it is recommended that cephalosporin is preferred because it is a broad-spectrum antibiotic with relatively low toxicity. Cephalosporin is mainly for the treatment of bacterial infections, while azithromycin is mainly for the treatment of mycoplasma. It is also necessary to specify which pathogenic bacteria first according to the child’s diagnosis before choosing the specific medication, in addition, it is also necessary to consider whether the child is allergic to cephalosporin and other situations. The antibacterial spectrum of cephalosporin is relatively broad, and cephalosporin has a good antibacterial effect on both some gram-positive and gram-negative bacteria. Azithromycin is used to treat acute pharyngitis and acute tonsillitis caused by Streptococcus pyogenes. Acute attacks of sinusitis, otitis media, acute bronchitis, chronic bronchitis caused by sensitive bacteria. Pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae. Urethritis and cervicitis due to Chlamydia trachomatis and non-multiple drug-resistant Neisseria gonorrhoeae. Skin and soft tissue infections caused by sensitive bacteria. The antibacterial range of cephalosporins is greater than that of azithromycin.