Objective To investigate the efficacy and adverse reactions of azithromycin sequential therapy for the treatment of children with mycoplasma pneumonia.Methods 84 children with mycoplasma pneumonia were randomly divided into study group and control group according to the digital table,with 42 cases in each group.The study group was given azithromycin treatment,and the control group was given erythromycin treatment.The clinical curative effect and adverse reaction were compared between the two groups.Results The total effective rate of the study group (97.62％) was significantly higher than that of the control group (76.19％),and the difference was statistically significant (x2 =11.95,P ＜ 0.05).The pyretolysis time [(3.78 ± 1.57) d],cough improvement time [(3.29 ± 0.74) d],rate disappearance time[(5.88 ± 2.35) d],average hospitalization time [(8.89 ± 1.76) d] of the study group were significantly shorter than those of the control group [(4.49 ± 1.71) d,(4.28 ± 0.77) d,(7.69 ±2.54) d,(10.05 ± 2.27) d],and the differences were statistically significant (t =2.01,6.33,3.29,2.46,all P ＜0.05).The incidence rate of adverse reactions such as nausea,abdominal distention,abdominal discomfort,local injection pain,rash,elevated alanine aminotransferase of the study group (4.76％) was significantly lower than that of the control group (19.05％),and the difference was statistically significant (x2 =4.86,P ＜ 0.05).Conclusion Azithromycin sequential therapy is effective in the treatment of children with mycoplasma pneumonia.It can effectively shorten the disappearance time of clinical symptoms and signs,and average hospitalization time,and has low incidence rate of adverse reactions.It is worthy of clinical use.