Doxycycline vs Azithromycin
DoxycyclineAzithromycin
Generally less expensiveCostTypically more expensive than doxycycline.
Tetracycline AntibioticDrug ClassMacrolide Antibiotic
Inhibits bacterial protein synthesis by binding to 30S ribosomal subunit.Mechanism of ActionInhibits bacterial protein synthesis by binding to 50S ribosomal subunit.
Broad-spectrum, effective against Gram-positive, Gram-negative, and atypical bacteria.Spectrum of ActivityEffective against Gram-positive, Gram-negative, and atypical bacteria, with a focus on respiratory pathogens.
Acne, respiratory infections, Lyme disease, malaria prophylaxis, STIs (chlamydia), and rickettsial infections.Common IndicationsRespiratory infections, skin infections, STIs (chlamydia), and otitis media.
Oral tablets, capsules, and IV.Dosage FormsOral tablets, capsules, suspension, and IV.
100 mg twice daily for most infections.Usual Adult Dosage500 mg on day 1, followed by 250 mg daily for 4 days (typical regimen).
Approximately 16–22 hours.Half-LifeApproximately 68 hours.
7–14 days, depending on the infection.Duration of TherapyTypically 3–5 days due to long half-life.
Minimal hepatic metabolism; primarily excreted unchanged in urine and feces.MetabolismHepatic metabolism (via CYP3A4); excreted in bile and feces.
Category D (use only if benefits outweigh risks).Pregnancy CategoryCategory B (generally considered safer in pregnancy).
Nausea, vomiting, photosensitivity, esophageal irritation, diarrhea.Side EffectsNausea, diarrhea, abdominal pain, potential QT prolongation.
Antacids, calcium, iron, and magnesium reduce absorption; increases warfarin effect.Drug InteractionsAvoid with antacids; increases effects of warfarin and digoxin; risk of QT prolongation with certain drugs.
Hypersensitivity to tetracyclines, pregnancy, and children under 8 years (due to teeth discoloration).ContraindicationsHypersensitivity to macrolides; caution in patients with QT prolongation.
Broad-spectrum activity, effective against rickettsial diseases, and malaria prevention.Key AdvantagesShorter treatment duration, well-tolerated, effective against respiratory infections.
Photosensitivity and esophageal irritation; not suitable for pregnant women or young children.Key DisadvantagesPotential for QT prolongation and resistance in some pathogens.
Resistance developing in some bacteria, including some Gram-negative strains.Resistance ConcernsEmerging resistance in Streptococcus pneumoniae and some Gram-negative strains.
Store at room temperature away from light and moisture.Storage RequirementsStore at room temperature away from light and moisture.
Widely availableAvailabilityWidely available
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