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Key takeaways
Augmentin (amoxicillin-clavulanate) is widely used for various bacterial infections. However, it may fail or cause side effects, leading to consideration of alternatives such as amoxicillin, Cefdinir, Zithromax, Vibramycin, and Levaquin.
Alternatives to Augmentin span different antibiotic classes, including penicillins, cephalosporins, macrolides, tetracyclines, and fluoroquinolones, to suit different bacterial infections and patient needs.
Amoxicillin is highlighted as a common alternative despite its lesser antibiotic activity without clavulanate. It also has potentially fewer side effects, like diarrhea.
Switching to an Augmentin alternative requires consultation with a healthcare provider to ensure the alternative is appropriate for the infection and to manage the transition safely.
The usefulness of amoxicillin-clavulanate and its brand-name version, Augmentin, is extensive. From sinusitis and pneumonia to acute diverticulitis and emphysema exacerbations, the antibiotic action of Augmentin can tackle a broad spectrum of bacteria. However, this drug’s utility is not perfect, so you may be interested in an alternative due to the failure of Augmentin to eradicate whatever infection you might be dealing with. You are more likely dismayed by one or more of Augmentin’s pesky side effects, risk factors, and drug interactions or have had an allergic reaction. Either way, you have other options to consider and learn more about.
RELATED: Augmentin side effects and how to avoid them
What can I take in place of amoxicillin clavulanate?
Augmentin has two components, most importantly amoxicillin, which falls within the penicillin family of antibiotics. This storied family kills bacteria by inhibiting enzymes within the bacterial cell wall. All penicillins have a structural similarity, a beta-lactam ring, but their actions can differ.
Some have more potency than Augmentin against certain bacteria, and others have a more narrow spectrum of bacterial killing, which can mean fewer adverse effects. Augmentin gains more antimicrobial effectiveness via its second component, clavulanate, which can inhibit a bacteria’s beta-lactamase enzyme and thus help to avoid bacterial resistance to amoxicillin. Based on differences between members of the penicillin family, another penicillin member could be an option for you even if Augmentin fails.
Cephalosporins are an alternative antibiotic class with a beta-lactam structure like penicillins, but they are different enough to usually avoid an allergic reaction in those who have had non-severe reactions to Augmentin or other penicillins in the past. Sulfonamides, macrolides, tetracyclines, and quinolones are other antibiotic classes that can replace Augmentin if needed. To figure out which might suit you best, let’s delve into the details.
Compare Augmentin (amoxicillin clavulanate) alternatives |
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| Drug name | Uses | Dosage | Savings options |
| 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 |
| 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 |
| Penicillin V Potassium | Bacterial infections, streptococcal pharyngitis, rheumatic fever prophylaxis | 125 to 500 mg every 6 to 12 hours depending on 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 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 gm intramuscular injection or intravenous every 12 to 24 hours depending on indication | Ceftriaxone sodium coupons |
| Bactrim DS (sulfamethoxazole-trimethoprim) | Bacterial infections, urinary tract infection, pneumocystis carinii | 800 mg/160 mg twice-daily depending on 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 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 indication | Cleocin coupons |
Other alternatives to amoxicillin clavulanate
- Cefadroxil
- Cefpodoxime
- Trimethoprim-sulfamethoxazole liquid
- Ery-tab (erythromycin)
- Tetracycline
- Minocycline
- Moxifloxacin
- Macrobid
Top 5 amoxicillin clavulanate alternatives
The following are some of the most common alternatives to amoxicillin clavulanate.
1. Amoxicillin
You might be surprised to see amoxicillin headline this list. Although it kills a broader array of bacteria than plain penicillin V potassium, amoxicillin has less antibiotic activity than Augmentin due to clavulanate’s absence, which helps avoid bacterial resistance. In addition, amoxicillin is certainly a penicillin, so it will not prevent an allergic reaction if someone has reacted to Augmentin in the past.
Amoxicillin makes the list because the lack of clavulanate can mean less of a chance of diarrhea. This is significant because diarrhea can strike 9% of Augmentin users or more. If diarrhea side effects have you looking for a different antibiotic treatment, amoxicillin could be a reasonable choice.
It is important to note that diarrhea from antibiotics could be a sign of a serious infection called C. diff from the Clostridium difficile bacteria. You should contact your healthcare provider if you have significant diarrhea while on an antibiotic or soon afterward.
The liquid formulation of amoxicillin was placed on the Food and Drug Administration’s drug shortage list in November 2022. This was a major cause for concern among parents due to the medicine’s prominent use for ear infections and strep throat from group A streptococcus bacteria. Fortunately, chewable tablets were available, and supply chain issues usually do not factor in deciding which antibiotic to take. On the other hand, the expense of a drug can undoubtedly be an issue. Fortunately, most common antibiotics are generic, and the SingleCare discount card is available to assist with savings.
2. Cefdinir
Cephalosporins are an antibiotic class with multiple subcategories or generations, each with different uses. Second and third-generation cephalosporins could be a good substitute for Augmentin because they have some ability to defeat both gram-positive and gram-negative types of bacteria. For example, cefdinir can be chosen for acute otitis media and pneumonia because it defeats beta-lactamase-producing bacteria resistant to penicillin and amoxicillin. Another example is ceftriaxone, an injectable third-generation cephalosporin that can be administered in the doctor’s office.
Besides treating respiratory tract infections, these agents can also be effective for urinary tract infections. The option for once-daily dosing of cefdinir and the availability of a tasty liquid version are two reasons cefdinir could be more appealing than Augmentin.
3. Zithromax
Zithromax is another option for respiratory tract infectious disease, particularly for those allergic to penicillin. This macrolide drug is dosed once daily and only requires a five-day treatment course. Unfortunately, bacterial resistance rates have risen and reduced the utility of macrolides. Accordingly, Zithromax is not a first-line drug for acute bacterial sinusitis or acute otitis media.
4. Vibramycin
Doxycycline, or brand-name Vibramycin, can substitute for Augmentin in cases of sinusitis and pneumonia. The tetracycline antibiotic is an alternative for those allergic to penicillins or not responding to penicillins. Adverse effects of tetracyclines are typically the limiting factor in their use, particularly stomach upset and sun sensitivity, as well as the fear of dental staining with long treatment courses in young children.
5. Levaquin
The fluoroquinolone antibiotic Levaquin has plenty of positive attributes that might catch your attention. Its effectiveness for respiratory, gastrointestinal, and urinary system infections makes it an attractive choice. These choices are rarely easy, though. Levaquin can cause havoc when it comes to its negative effects. A penchant for causing C. diff infections and a potential for nerve and tendon damage are major reasons to hesitate before choosing Levaquin.
Natural alternatives to amoxicillin clavulanate
By this point, you recognize that choosing an antibiotic requires decision-making that balances the benefits of having more powerful bactericidal potential with the risks, namely the eradication of beneficial bacteria in the intestinal tract, leading to diarrhea. You may also be interested in knowing if a non-pharmacologic or over-the-counter option exists so you do not have to take a prescription drug. Taking a step back, the real question is whether you need antibiotic therapy. That is a valid question to ask your healthcare provider. If an ear or lung infection, for example, is caused by a virus, then an antibiotic will not be effective, and a tincture of time may be all that is needed. However, if the healthcare professional feels your infection is bacterial and an antibiotic is necessary, looking for a natural alternative may be foolhardy.
How to switch to an amoxicillin clavulanate alternative
Any infection treated by Augmentin have the potential to be serious. Complications can arise from common infections like pneumonia, sinusitis, and urinary tract infections. If you are doubtful about taking Augmentin and are considering any alternatives, immediately talk to the prescribing medical provider for medical advice. A conversation about what concerns you about Augmentin and what other options interest you is worthwhile and the only way to proceed safely. These are not decisions you can make on your own.