Objective: To probe into the efficacy and safety of azithromycin in the adjuvant treatment of upper airway cough syndrome (UACS) induced by allergic rhinitis in children

and to further study the effective mechanism. Methods: By using the method of random

open

single-blind and parallel controlled trial

140 children diagnosed with UACS induced by allergic rhinitis in the pediatric outpatient department of our hospital from Apr. 2013 to Apr. 2019 were extracted to be randomly divided into the treatment group and the control group

with 70 cases in each group. Both groups were treated with oral montelukast sodium combined with mometasone furoate nasal spray. On this basis

the treatment group received oral azithromycin

while the control group was given oral placebo. Results: After treatment of 10 d

the scores of cough symptom and visual analogue scale of two groups were significantly improved (P<0.05)

and the improvement of the treatment group was better than that of the control group (P<0.01). The total effective rate in the treatment group was higher than that in the control group (P<0.05). After treatment of 14 d

the levels of nitric oxide

tumor necrosis factor-α and serum total immunoglobulin E were significantly improved in both groups (P<0.01)

and the improvement in the treatment group was better than that in the control group (P<0.01). During the treatment

some children (1.42%) had mild gastrointestinal reactions

no other adverse drug reactions were observed

and no abnormalities in blood routine

liver and kidney function were observed in both groups at the end of treatment. Conclusion: Azithromycin is effective and safe in the treatment of UACS induced by allergic rhinitis in children. Its mechanism may be related to anti-inflammatory and immunomodulatory effects.