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Key takeaways
Alternatives to amoxicillin include Augmentin, cephalexin, cefdinir, Zithromax, and Vibramycin. The right choice depends on the type of infection, patient allergies, and the potential for bacterial resistance.
To ensure effective and safe treatment, switching to an alternative antibiotic must consider the bacteria causing the infection, the patient’s health history, and potential drug interactions.
Many sinus and ear infections are viral and unaffected by antibiotics, highlighting the importance of accurate diagnosis before antibiotics are prescribed.
Looking for an alternative to amoxicillin has always been necessary at times due to drug allergy or ineffectiveness. Still, in late 2022, the need reached a fever pitch due to the shortage of antibiotics. The oral powder form of amoxicillin, used by pharmacists in making liquid amoxicillin, went on the Food and Administration (FDA) drug shortage list in November 2022. As one of the most common prescriptions in the nation, the news was particularly troubling entering the winter season, when there is increased demand for liquid amoxicillin due to childhood sinus and ear infections. Thankfully, if weight-based dosing worked out, amoxicillin chewable tablets could be used instead, or capsules could be opened and poured on applesauce, according to the American Academy of Pediatrics. Dosing guidelines do not always allow for tablets or capsules of the drug to work out, so it is helpful to know that other antibiotics can usually be substituted for amoxicillin. We will introduce you to the common alternatives.
What can I take in place of amoxicillin (Amoxil)?
Amoxicillin belongs to the penicillin class of antibiotics. Other class members could be considered if amoxicillin is unavailable. The class has had a long and celebrated role in medicine, but it is a class many people cannot use due to a possible allergy. Cephalosporin antibiotics may be an option in these cases if the reaction is only a rash. Although cephalosporins and penicillins have a beta-lactam chemical structure, the forms are sufficiently different to allow cephalosporin use in some with penicillin allergies. With a history of more severe penicillin-allergic reactions, a different antibiotic class could be turned to, such as a member of the sulfonimide, macrolide, tetracycline, or quinolone groups.
These other antibiotics could also be called upon if bacterial resistance to penicillins is a concern, a not uncommon problem due to beta-lactamase enzyme production by bacteria. In fact, amoxicillin is combined with clavulanic acid, a beta-lactamase inhibitor, to make Augmentin-resistant bacteria. The details of this antibiotic and other alternatives to amoxicillin are important to know.
Compare Amoxil (amoxicillin) alternatives |
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| Drug name | Uses | Dosage | Savings options |
| Amoxicillin | Bacterial infections, streptococcal pharyngitis (strep throat), acute otitis media (ear infection), acute bacterial sinusitis, community-acquired pneumonia, Helicobacter pylori infection (H. pylori), Lyme disease (off-label) | 500 to 1000 mg every 8 to 12 hours depending on indication in adults (dosing for pediatric patients is dependent on age, weight, and indication) | Amoxicillin coupons |
| Augmentin (amoxicillin-clavulanic acid) | Bacterial infections, acute bacterial sinusitis, urinary tract infection, community-acquired pneumonia | 500 mg/125 mg to 875 mg/125 mg every 8 to 12 hours depending on indication | Augmentin coupons |
| Penicillin V Potassium | Bacterial infections, streptococcal pharyngitis, rheumatic fever prophylaxis | 125 to 500 mg every 6 to 12 hours, depending on the indication | Penicillin V Potassium coupons |
| Cephalexin | Bacterial infections, streptococcal pharyngitis, urinary tract infection, skin, and soft tissue infection | 250 to 500 mg every 6 to 12 hours, depending on the indication | Cephalexin coupons |
| Cefuroxime axetil | Bacterial infections, streptococcal pharyngitis, acute bacterial sinusitis, Lyme disease | 250 to 500 mg twice daily | Cefuroxime coupons |
| Cefdinir | Bacterial infections, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia | 300 mg every 12 hours | Cefdinir coupons |
| Suprax (cefixime) | Bacterial infections, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia, urinary tract infection, gonococcal infection | 400 mg once daily or 800 mg once for uncomplicated gonococcal infection | Suprax coupons |
| Ceftriaxone sodium | Bacterial infections, bacterial meningitis, community-acquired pneumonia, gonococcal infection, urinary tract infection, pelvic inflammatory disease (PID) | 1 to 2 g intramuscular injection or intravenous every 12 to 24 hours, depending on the indication | Ceftriaxone sodium coupons |
| Bactrim DS (sulfamethoxazole-trimethoprim) | Bacterial infections, urinary tract infections, pneumocystis carinii | 800 mg/160 mg twice daily, depending on the indication | Bactrim DS coupons |
| Zithromax (azithromycin) | Bacterial infections, streptococcal pharyngitis, acute bacterial exacerbation of COPD, community-acquired pneumonia, chlamydia infection, PID, chancroid, mycobacterium avium complex | 250 to 500 mg once daily, depending on the indication | Zithromax coupons |
| Clarithromycin | Bacterial infections, streptococcal pharyngitis, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia, chlamydia infection, PID, chancroid, mycobacterium avium complex, H. pylori infection | 250 to 500 mg twice daily | Clarithromycin coupons |
| Vibramycin (doxycycline hyclate) | Bacterial infections, acute bacterial sinusitis, community-acquired pneumonia, chlamydia infection, acne vulgaris, syphilis, lymphogranuloma venereum, anthrax, Rocky Mountain Spotted Fever, tularemia, brucellosis, cholera, malaria prophylaxis, Lyme disease (off-label) | 100 mg twice daily | Vibramycin coupons |
| Levofloxacin | Pneumonia, prostatitis, urinary tract infection, skin and soft tissue infection, acute bacterial exacerbation of chronic bronchitis, acute bacterial sinusitis, plague, anthrax | 250 to 750 mg once daily | Levofloxacin coupons |
| Cipro (ciprofloxacin) | Bacterial infections, prostatitis, urinary tract infection, bone and joint infection, intra-abdominal infection, hospital-acquired pneumonia, typhoid, plague, anthrax | 250 to 750 mg every 12 hours | Cipro coupons |
| Cleocin (clindamycin) | Bacterial infections, streptococcal pharyngitis, bacterial vaginosis | 150 to 450 mg every 6 to 12 hours, depending on the indication | Cleocin coupons |
Other alternatives to amoxicillin
- Cefadroxil
- Cefpodoxime
- Trimethoprim-sulfamethoxazole liquid
- Ery-tab (erythromycin)
- Tetracycline
- Minocycline
- Moxifloxacin
- Macrobid
Top 5 amoxicillin alternatives
The following are some of the most common alternatives to amoxicillin.
1. Augmentin
If an amoxicillin shortage has you looking for another option, Augmentin (amoxicillin-clavulanate) makes a lot of sense, since this product contains amoxicillin along with clavulanate and is available in liquid and tablet forms. Adding the beta-lactamase inhibitor clavulanate fends off certain bacteria that would be resistant to plain amoxicillin. The enhanced action works for many ear, sinus, and lung infections cases. The downside of having more antibiotic power is a tendency for more adverse effects like diarrhea.
RELATED: Amoxicillin vs. Augmentin: Differences, similarities, and which is better for you
2. Cephalexin
If you have a history of a minor rash with prior amoxicillin use, cephalexin might make a good substitute. It is a first-generation cephalosporin. Cephalexin is a common pick for strep throat and skin infections like cellulitis.
RELATED: Cephalexin vs. Amoxicillin: Differences, similarities, and which is better for you
3. Cefdinir
Advancing to a third-generation like cefdinir can provide you with a broader spectrum of antibiotic action. Accordingly, cefdinir can be chosen for acute otitis media and pneumonia, even when amoxicillin has been ineffective. Ceftriaxone is an injectable third-generation cephalosporin that can be administered in the doctor’s office. These agents can also be effective for urinary tract infections, a condition for which amoxicillin is not often chosen. The once-daily dosing of cefdinir is nice as well. Unfortunately, killing more bacteria means eradicating more good bacteria from the intestinal tract, and therefore, healthcare providers typically recommend not using a more potent antibiotic than is necessary. The quinolone antibiotic levofloxacin is a good example of a powerful antibiotic that is usually avoided if other options will work.
RELATED: Cefdinir vs. amoxicillin: Differences, similarities, and which is better for you
4. Zithromax
Zithromax (azithromycin) has been a popular pick for strep throat and respiratory tract infectious diseases for those who are allergic to penicillin. The macrolide drug’s once-daily dosing and five-day treatment course have won it plenty of fans. Unfortunately, more recently, bacterial resistance rates to macrolides have tempered the enthusiasm, so Zithromax is not a recommended first choice for most folks with acute bacterial sinusitis or acute otitis media.
RELATED: Azithromycin vs. amoxicillin: Differences, similarities, and which is better for you
5. Vibramycin
Sinusitis, pneumonia, and Lyme disease are all in the wheelhouse of Vibramycin, the brand name of doxycycline. These uses make this tetracycline antibiotic an option in many cases where amoxicillin cannot be used or is ineffective. The downsides of tetracyclines are worth noting. Stomach upset, and sun sensitivity can be significant, and young children fear dental staining with long treatment courses.
RELATED: Why you should take probiotics with antibiotics
Natural alternatives to amoxicillin
When you truly have a bacterial infection and need amoxicillin, it is unlikely that your healthcare provider’s medical advice would be to use a natural alternative. The more pertinent question is if you have a bacterial infection. Many sinus and ear infections are caused by viruses unaffected by antibiotics. The healthcare professional evaluating you will likely take into account infection factors like severity and timeframe and patient factors like your age and health history to help determine if antibiotics are needed. This determination can be difficult, but it is critically important not to unnecessarily expose you to antibiotic side effects.
How to switch to an amoxicillin (Amoxil) alternative
Finding an alternative to amoxicillin is quite possible whether you need a different option due to a drug shortage, allergy, ineffectiveness, or cost. The selection process must consider what bacteria is likely to be causing the infection and what antibiotic is strong enough to get the job done without being excessive. Your clinicians will want to cross-reference your list of prescription medications, over-the-counter drugs, and supplements to look for drug interactions. When it is all said and done, you can expect to be set up with a different antibiotic and be on your way to feeling better.
