Abstract: Abstract Objective   To explore the intervention effect of Azithromycin in recurrence and(or) relapse on the glucocorticoid reduction course of primary nephrotic syndrome in children. Methods   One hundred and seventy-nine patients who had a relapse/ recurrence of nephrotic syndrome were randomly divided into treatment group and control group. Treatment group patients were treated with azithromycin 10 mg/kg each day, 3 days for a course, and the patients of control group were given non-macrolide antibiotics, oral or intravenous. The clinical and laboratory data [age, gender, weight, repeated/recurrence condition, the time of NS, the daily dosage of GC, the total time of GC cumulative application, 24 h urine protein quantitative (24 h - Upro), blood total protein (Tp), albumin (Alb), cholesterol (Tcho), urea nitrogen (Bun), serum creatinine (Scr), immune globulin (IgA, IgG, IgM, IgE), complement (C3, C4), blood mycoplasma IgM antibody positive ratio, etc]were analyzed by single and multiple regression analysis. Results  No significant difference was found in clinical and laboratory data between treatment group and control group and between Azithromycin effective group and Azithromycin ineffective group. There were significant differences on the efficient of treatment group (75.28%) and control group (34.44%). Urinary protein qualitative degree and the length days of urine protein before the treatment was different between the Azithromycin effective group and Azithromycin ineffective group. The non-conditional logistic regression analysis of treatment group revealed that the higher efficiency appear in the cases with the shorter duration days of Urinary protein before treatment. Conclusion  Azithromycin is effective in the early stage of PNS relapse/ recurrence children. Azithromycin maybe used as a steroid-sparing medicine. Azithromycin will provide a new treatment option to the PNS children with relapse or recurrence.

Key words: nephrotic syndrome, glucocorticoids, Recurrence, children, azithromycin