Abstract: Macrolide antibiotics have been developed since a long time ago with various types，and are widly used in clinical practice，which rank No.1 in the use of antibiotics in domestic pediatric outpatient departments. Macrolide antibiotics have a strong antibacterial effect on a variety of pathogens，however the resistance rate of pediatric isolates of Streptococcus，Staphylococcus and Mycoplasma pneumoniae to macrolide antibiotics is also very prominent. The 14-membered and 15-membered ring macrolides have some anti-inflammatory and immunomodulatory effects in addition to broad-spectrum antibacterial activity. Given that children’s dynamic physiological development differs from adults’，it is urgent to have a specific guidance document for the clinical application of macrolides in children. The consensus gives a systematic summary of drug characteristics，pharmacokinetics and pharmacodynamics of macrolide antibiotics；meanwhile，the consensus gives comprehensive recommendations on the use of macrolide antibiotics in children with infectious diseases，adverse reactions and non-antibacterial effects，so as to standardize their rational clinical use.

Key words: antimicrobial drugs, macrolides, consensus, child

摘要： 大环内酯类抗菌药物问世久远、种类繁多，是临床广泛使用的抗菌药物，高居国内儿科门诊抗菌药物使用量的首位。大环内酯类抗菌药物对多种病原微生物有较强的抗菌作用，但中国儿童中链球菌属、葡萄球菌属、肺炎支原体等对大环内酯类抗菌药物的耐药率也很突出。14元环和15元环大环内酯类抗菌药物除广谱的抗菌活性外，还具有一定的抗炎和免疫调节效应。儿童有不同于成人的生理特点，亟需一个专门针对大环内酯类抗菌药物临床应用的指导文件。该共识从大环内酯类抗菌药物的药物特点、药代动力学和药效学特点、在儿童感染性疾病中的作用、不良反应及抗菌外作用等方面给出了全面建议，以规范其临床合理使用。

关键词: 抗菌药物, 大环内酯类, 共识, 儿童