There have been clinical reports of renal injurious disease following administration of the drug, but it could not be demonstrated to be drug-related; azithromycin is currently thought to cause renal damage on rare occasions. Azithromycin is a commonly used clinical macrolide anti-infective drug for the treatment of pneumonia, urethritis, and skin infections caused by diseases such as Chlamydia, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae. The drug is mainly metabolized by the liver and excreted through the bile. There are clinical reports that after the use of azithromycin, there are cases of interstitial nephritis, acute renal failure and other diseases, but it can not be proved that the above diseases are indeed caused by azithromycin, so the drug’s nephrotoxicity is relatively low, and the requirements for renal function are not strict, mild to moderate renal impairment can be used with the drug, and does not need to be adjusted in dosage; severe renal insufficiency needs to be used with caution. Common adverse reactions to the drug include palpitations, vomiting, cholestatic jaundice, dizziness, headache, skin rash, etc., and the above symptoms should be discontinued. The drug is contraindicated in cases of allergy to the drug, previous use of erythromycin, other macrolides, cholestatic jaundice, patients with a history of hepatic insufficiency, and pneumonia due to a serious illness that makes oral treatment inappropriate. Azithromycin needs to be administered under the supervision of a clinician.