Azithromycin vs Amoxicillin
AzithromycinAmoxicillin
Macrolide AntibioticDrug ClassPenicillin Antibiotic
Inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, preventing bacterial growth.Mechanism of ActionInhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs).
Broad-spectrum: Gram-positive, Gram-negative, and atypical bacteria (e.g., Mycoplasma, Chlamydia).Spectrum of ActivityPrimarily effective against Gram-positive bacteria; some Gram-negative activity.
- Respiratory tract infections (e.g., bronchitis, pneumonia). - Skin infections. - Sexually transmitted infections (e.g., chlamydia). - Ear infections (otitis media).Common Indications- Respiratory tract infections (e.g., sinusitis, pneumonia). - Ear infections (otitis media). - Skin and soft tissue infections. - Urinary tract infections (UTIs). - Dental infections.
- Tablets. - Suspension. - Injection.Dosage Forms- Tablets. - Capsules. - Suspension.
- Adults: 500 mg on day 1, followed by 250 mg once daily for 4 days. - Children: 10 mg/kg on day 1, then 5 mg/kg once daily for 4 days.Typical Dosage- Adults: 500–875 mg every 8–12 hours. - Children: 20–50 mg/kg/day divided every 8–12 hours.
Shorter courses (e.g., 3–5 days).Duration of TreatmentTypically 7–14 days, depending on infection.
Category B (No evidence of risk in humans).Pregnancy CategoryCategory B (No evidence of risk in humans).
- Nausea. - Diarrhea. - Abdominal pain. - Vomiting.Common Side Effects- Nausea. - Diarrhea. - Rash. - Allergic reactions.
- QT prolongation (cardiac arrhythmia). - Liver toxicity.Serious Side Effects- Severe allergic reactions (e.g., anaphylaxis). - Stevens-Johnson syndrome.
- Antacids (reduce absorption). - QT-prolonging drugs (e.g., amiodarone).Drug Interactions- Allopurinol (increased rash risk). - Oral contraceptives (reduced efficacy).
- Hypersensitivity to macrolides. - History of liver dysfunction from prior azithromycin use.Contraindications- Hypersensitivity to penicillins or beta-lactams.
- Half-life: ~68 hours (longer tissue distribution). - Metabolism: Minimal hepatic metabolism. - Excretion: Primarily biliary.Pharmacokinetics- Half-life: ~1 hour. - Metabolism: Minimal hepatic metabolism. - Excretion: Primarily renal.
Typically higher than amoxicillin.CostGenerally more affordable than azithromycin.
- Shorter dosing regimens. - Effective against atypical bacteria.Advantages- Effective against common bacterial infections. - More affordable.
- Risk of QT prolongation. - More expensive.Disadvantages- Requires more frequent dosing. - Limited spectrum against atypical bacteria.
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