Objectvie:Intravenous azithromycin(AZM)has been widely used in children worldwide,but there still remains much concern regarding its off-label use,which urgently needs to be regulated.Therefore,we developed a rapid advice guideline in China to give recommendations of rational use of intravenous AZM in children.

Methods:This guideline focuses on antimicrobial therapy with intravenous AZM in children.The Delphi research method was used to select the questions.A systematic literature review was also conducted.Data were pooled and ranked according to the GRADE system.Recommendations were developed based on expert clinical experience,patients’values and preferences,and evidence availability.After an external review,the recommendations were revised and approved.

Results:This guideline included eighteen recommendations that covered four domains:1)Indications:the treatment of pneumonia caused by atypical but common pathogens,such as Mycoplasma pneumoniae(M.pneumoniae),Chlamydia trachomatis(C.trachomatis)or Chlamydophila pneumoniae(C.pneumoniae)and Legionella pneumophila(L.pneumophila),more typical bacteria as well as the treatment of bronchitis of presumed bacterial aetiologies;2)Usage and dosage:administration route,infusion concentrations,treatment duration,course of sequential treatment,and dosage stratified by age;3)Adverse reactions and treatment:the management of gastrointestinal reactions,arrhythmias,pain or phlebitis at the infusion site,and anaphylaxis;and 4)Special population:children with renal or liver dysfunction,congenital heart disease,and obesity.This guideline will hopefully help promote a rational use of intravenous AZM in children worldwide.

Conclusion:This guideline has summarized the evidence and have developed recommendations on the use of intravenous AZM in children worldwide.Further attention and well-designed researches should be conducted on off-label use of intravenous AZM in children.

Objectvie：静脉注射阿奇霉素 (AZM) 已在全球儿童中广泛使用，但其超说明书使用仍存在很多问题，亟待监管。因此，我们在中国制定了快速建议指南，以给出儿童合理使用静脉注射 AZM 的建议。

方法：本指南重点关注儿童静脉注射 AZM 的抗菌治疗。采用 Delphi 研究方法选择问题。还进行了系统的文献综述。根据 GRADE 系统汇总数据并进行排序。根据专家临床经验、患者的价值观和偏好以及证据可用性制定建议。外部审查后，对建议进行了修订和批准。

结果：本指南包括18项建议，涵盖了4个领域：1）适应症：治疗非典型但常见病原体引起的肺炎，如肺炎支原体 (M.pneumoniae)、沙眼衣原体 (C.trachomatis) 或肺炎衣原体 (C.pneumoniae) 和嗜肺军团菌 (L.pneumophila)，更典型的细菌以及治疗假定细菌病因的支气管炎；2）用法用量：给药途径、输注浓度、治疗持续时间、序贯治疗疗程和按年龄分层的剂量；3）不良反应和治疗：胃肠道反应、心律失常、输注部位疼痛或静脉炎以及过敏反应的管理；和4）特殊人群：肾或肝功能不全、先天性心脏病、本指导原则将有助于促进全球儿童静脉使用AZM。

结论：本指导原则总结了证据，并对全球儿童静脉使用 AZM 提出了建议。应进一步关注儿童静脉使用 AZM 的超说明书用药并进行精心设计的研究。