Amoxicillin vs. Azithromycin: Which One You Should Be Using

Modern pharmaceutical science has a lot to offer regarding various medications that can be used to address dozens of medical conditions. However, sometimes this diversity is rather a drawback than an advantage because it is hard to decide which medicine is going to work best in each patient’s individual case. This is especially true for situations when patients decide to skip the appointment with a medical practitioner and go on straight to buying OTC medications or just ordering from online pharmacies. Amoxicillin and azithromycin are two popular antibiotics which are frequently used without consulting a doctor first. If you intend to do so or simply are curious as to why your healthcare provider chose to prescribe you one of these antibiotics, you will find a lot of helpful information in this article, which explains the differences between these two medicines and provides general information about them.

What You Need to Know about Amoxicillin

Amoxicillin belongs to the penicillin group of antibiotics. Due to its ability to fight various bacteria types, it is commonly used to address many bacterial infections, such as pneumonia, some sexually transmitted diseases, tonsillitis and a variety of ear, nose, skin, urinary tract and throat infections. Paired with clarithromycin, amoxicillin is often prescribed for patients who suffer from stomach ulcers caused by Helicobacter pylori bacteria.

Amoxicillin is available in some branded medication forms, and the usage instructions for them may vary. Check your prescription label or the patient information leaflet that came with the medication for detailed information on how you should take amoxicillin. Generally, it is to be taken at regular intervals every day to achieve maximum efficiency. Depending on the amoxicillin form you have, it may have to be taken with or without food. Make sure that you do not crush, chew or damage the coating of an extended-release amoxicillin tablet in any other way.

Amoxicillin is known to affect kidney and liver function so your health care provider might advise you to have blood tests on a regular basis while you are using amoxicillin. Because of this, it is important that you do not share your amoxicillin pills with other people, even if they have symptoms that are similar to yours.

Do not stop taking amoxicillin even if you feel better shortly after you have started using it. Doing so (and in some cases, even skipping doses) may lead to the bacteria in your body becoming resistant to amoxicillin, so that they can no longer be killed off by the antibiotic. Do not change the amoxicillin dosage of your own accord without consulting your healthcare provider first.

It is important that you store amoxicillin properly: avoid storing it in moist, well-lit places next to a source of heat. You cannot store amoxicillin in bathroom cabinets. Make sure that your supply of amoxicillin pills is well out of reach for children and household pets. If you are taking liquid amoxicillin, make sure that you only use it for 14 days after it has been mixed at the pharmacy. After a fortnight of usage, you should throw away the remains of the mixture even if you kept it stored in a fridge.

If you happen to miss an amoxicillin dose, take it as soon as you remember. However, if it is almost time to take the next one, skip the dose you missed and do not take a double dosage all at once. Doing so may result in developing adverse reactions to the medication, such as diarrhea. In the case of amoxicillin overdose, so not hesitate to get professional medical attention because your vital body functions may be endangered by the high concentration of amoxicillin in your blood.

Safety First: Amoxicillin Side Effects and Warnings

Ideally, you should consult your healthcare provider before you start taking amoxicillin so that he/she can determine whether you need this exact antibiotic and whether it is safe for you to use it.

The following medical conditions might make it dangerous or impossible for you to use amoxicillin:

• A history of developing adverse reactions to penicillin group antibiotics, such as amoxicillin, oxacillin or ticarcillin
• Asthma
• Liver disorders
• Kidney disorders
• Mononucleosis (commonly referred to as “mono”)
• A history of developing diarrhea as a result of taking antibiotics

Amoxicillin is not be used by breastfeeding mothers because it is known to be capable of passing into breast milk and harming a nursing baby. However, amoxicillin was found to be completely safe for pregnant women and their unborn children. Studies have shown that amoxicillin may cause a negative impact on the efficiency of birth control pills, so make sure that you use other birth control methods, such as condoms or diaphragms, during your amoxicillin treatment to avoid unwanted pregnancy.

Some patients can take amoxicillin without developing any undesired effects of the medicine, but in most cases, patients do develop amoxicillin side effects as their bodies adjust themselves to the impact of the medication. These adverse reactions are quite common and usually do not pose any threats. If left unattended, they normally go away within 2-3 days after the beginning of the treatment course. However, if these side effects persist and/or you find them particularly bothersome, you have to consult your healthcare provider about them.

The most common adverse reactions to amoxicillin include:

• Stomach disorders which cause diarrhea, vomiting, nausea and stomach pains
• Vaginal discharge and/or itching
• Mild to moderate headaches
• “Hairy,” swollen or black tongue

Other amoxicillin side effects are significantly less common, but they also have grave consequences and require professional medical attention to minimize the possible negative impact on patient’s health.

These more severe adverse reactions to amoxicillin are as following:

• Watery/bloody diarrhea
• Painful sores in the mouth, painful/complicated swallowing, swollen gums
• Cold or flu symptoms, coughing
• Fever
• Trouble breathing
• Severe skin adverse reactions, accompanied by fever, painful skin rashes, particularly in the upper body part and face, swelling in the facial area, a burning sensation in one or both eyes
• Muscle weakness, itching or tingling in the muscles, feeling of exhaustion
• Skin becoming easy to bruise, unusual bleeding from the nose, vagina, rectum or mouth
• Yellow or pale skin, yellow eyes, dark urine, small amounts of urine, feeling dizzy, exhausted or confused, fever

This is not the complete list of all adverse reactions to amoxicillin that you could experience, so you should watch out for any unusual symptoms shortly after you start taking amoxicillin. If you notice anything wrong about the way your body functions, consult your healthcare provider about it as soon as possible because you might need to have your amoxicillin dosage reduced or stop taking amoxicillin or have its dosage reduced. If you experience any side effects of amoxicillin that are not mentioned in the drug information leaflet, you might want to report it directly to the drug manufacturer or the respective authority in your country so that it can be referenced in the future editions of the leaflet.

Make sure that you mention all medications that you are currently taking (including the non-prescription ones and herbal additives) to your medical practitioner so that he/she can make sure that they do not have any dangerous Amoxicillin interactions. Amoxicillin is to be used with caution simultaneously with several major groups of drugs because their interaction with the antibiotics may increase the patient’s chances of developing side effects of either medicine or reduce the efficiency of one or both medications.

What Is Azithromycin and How to Use It

Similarly to amoxicillin, azithromycin is also an antibiotic, but the azithromycin drug class is different – it is one of the azalides. Azithromycin is used to treat bacterial infections, such as respiratory tract, ear, and skin infections. Also, it is also commonly prescribed to address sexually transmitted diseases.

Azithromycin is available both as a generic drug and as a branded medication – Zithromax. There is a special form of Zithromax – the Z-Pak – which is often used as a quick and easy way to treat STI and respiratory tract infections. Some forms of azithromycin are available as OTC medications, so it is crucial that you understand exactly why you are going to use this antibiotic and whether it is safe for you to do so without consulting your healthcare provider first.

For most azithromycin forms it does not matter whether you take the medication with or without food. However, it is advisable that you take the pills at regular intervals every day of your treatment course so that the concentration of azithromycin in your blood can build up gradually and evenly.

If you are taking the Z-Max oral suspension with extended release time, you should only take it on an empty stomach, so allow at least two hours to pass between taking an azithromycin dose and eating a meal. It is also important that you use this azithromycin form correctly. To mix a dose, pour the contents of one packet into two ounces of water and stir the medication to obtain an even consistency of the mixture. Drink the whole dose immediately, do not leave any of it for later. To make sure that you get the most of your azithromycin dose, add some more water to the glass after you have drunk the mixture, stir it gently and drink the remains of the medication. Do not drink liquid form azithromycin if the medication has been mixed and left unconsumed for 12 hours or more.

Azithromycin (similarly to many other antibiotics) is sometimes prescribed to address viral infections as a result of erratic judgment on the part of the doctor. Azithromycin cannot make you feel better if your infection is caused by a virus, and taking it in such cases would be useless.

Azithromycin has to be taken exactly as prescribed by your healthcare provider or according to the drug leaflet instructions for OTC medications. Do not stop taking it earlier than you are supposed to even if you feel better and your symptoms have disappeared. The harmful bacteria in your body may not be completely killed off yet, and interrupting your treatment course may result in another outbreak of the infection. This time the bacteria are likely to be indifferent to the impact of azithromycin, and you will have to go through another treatment course with another antibiotic to make sure that the infection is cleared from your body completely.

Azithromycin is to be stored just like most other medicines – away from sources of heat, light, and moisture. Do not store azithromycin in places which are easily accessible to children and household pets. Do not share azithromycin with other people even if their symptoms are fairly similar to yours. If you have any azithromycin left after your treatment course is over, you should dispose of it in a proper way. If you are not sure how to do that, ask your healthcare provider or local pharmacist for guidance.

Azithromycin Side Effects, Interactions, and Warnings

Similarly to amoxicillin, azithromycin is likely to cause some mild side effects when you first start taking it. When your body becomes accustomed to the impact of the antibiotic, these adverse reactions should disappear without any actions on your part. The most common azithromycin side effects include headaches, diarrhea, and upset stomach. If these side effects do not go away within several days after their first appearance or if they disrupt your normal lifestyle, you should consult your medical practitioner about them.

The more serious azithromycin side effects are as following:

• Bloody/watery diarrhea
• Severe stomach pains
• Chest pains, accompanied by headaches and feeling extremely dizzy or nauseated
• Signs of liver disorders – fever, dark urine, small amounts of urine, nausea, feeling of exhaustion, jaundice (yellow skin and/or eyes), lack of appetite, abnormal stools
• Symptoms of skin reactions – fever, swollen body parts, particularly in the facial area, skin rashes that quickly begin to blister, peel off and/or itch, a burning sensation in the eyes

If you happen to experience any of the azithromycin adverse effects listed above, you are to seek professional medical help immediately because experiencing such symptoms for a long time might cause permanent damage to your health. This is not a complete list of all serious azithromycin side effects, so it is advisable that you watch out for any abnormalities in your body while you are taking azithromycin.

Azithromycin baby adverse reactions include restlessness and vomiting while nursing or eating. In senior patients, azithromycin might cause potentially dangerous heart rate increases.

Before you start taking azithromycin, you or your doctor have to make sure that you are not suffering from any of the medical conditions below:

• Liver and/or kidney problems
• Heart rhythm disorders
• Cardiovascular diseases

If you have one of these conditions, it might be dangerous for you to take azithromycin. Ask your healthcare provider to help you find an alternative to azithromycin that you could use.

You are not supposed to be taking azithromycin if you have already taken it before and experienced serious side effects or if you know that you are allergic to it or another medication from the azalides drug class.

Azithromycin can be used safely by pregnant women, but it is still unknown whether it can pass into breast milk and harm a nursing child. Make sure that you inform your healthcare provider that you are pregnant or that you are breastfeeding a baby before you get a prescription for azithromycin. Azithromycin can be used to treat children, but only as long as they are older than 6 months. Azithromycin pediatric dosing has to be adjusted individually for each child by a healthcare professional. Do not give your child azithromycin that was prescribed to you  even if your symptoms are identical.

Read also: 10 Golden Rules of Antibiotics Use

Which One Is Better: Amoxicillin or Azithromycin?

There is no definite answer to this question because both antibiotics are fairly effective, but you have to understand the difference between them to be able to use them correctly according to the situation.

First of all, azithromycin has milder side effects which mostly apply to the gastrointestinal system of the body, while amoxicillin is capable of disrupting other organs and systems, such as kidneys, liver and skin. Second, amoxicillin is mostly prescribed to patients who suffer from urinary or respiratory tract infections, while azithromycin is more effective in case of skin infections and sexually transmitted diseases. Third, the patterns for taking these two medicines are quite different. If you need amoxicillin, you may be prescribed to take amoxicillin 500 mg pills up to three times per day (as long as your body weight is over 20 kg). Azithromycin is normally taken once a day for several days in a row. Also, azithromycin is not to be taken on a full stomach, while for amoxicillin it mostly does not matter.

Bottom line: both amoxicillin and azithromycin are good medications, which are effective in different situations. The choice of using amoxicillin or azithromycin depends on two factors: your medical history and your current medical condition. Both these antibiotics are going to do a good job as long as they were prescribed for the “right” condition.