In this study, we evaluated the efficacy of azithromycin in otolaryngologic infections and tissue penetration. Azithromycin is a new macrolide developed by Pfizer Pharmaceuticals. Azithromycin maintained sustained high tissue levels compared with serum levels following small doses administered over a short period of time. Furthermore, excellent efficacy was achieved with the 3 day regimen of azithromycin, comparable to 10 day regimens of other antibiotics. In summary, azithromycin was demonstrated to be a highly useful antibiotic in infections of ear, nose, and throat.