In recent years，there has been much more interest in a non⁃antimicrobial action and immuno⁃ modulatory effects of macrolides，which have become an important choice for the treatment of asthma，chronic obstructive pulmonary disease（COPD）and bronchiectasis. However，which patients are more likely to benefit from the treatment，how to use macrolide drugs more standardized in combination with the guidelines，and reduce the possible side effects，which poses a major challenge to clinical management. Therefore，combined with the British Thoracic Society（BTS）guidelines，this article focuses on the indications，selection basis and future issues of macrolides in patients with chronic respiratory diseases.