Amoxicillin vs. Augmentin: Which Works Best for Sinus Infections?
Key takeaways:
Viruses cause most sinus infections. But bacteria cause some infections and might require treatment with an antibiotic. Amoxicillin and Augmentin (amoxicillin/clavulanate) are two antibiotic options.
Both medications can cause side effects like diarrhea, nausea, and vomiting. They can sometimes cause severe allergic reactions or serious cases of diarrhea.
Amoxicillin and Augmentin are first-choice medications for treating bacterial sinus infections. Augmentin may be best for people with certain risk factors or more serious infections.
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Sinus infections (also known as sinusitis) can affect anyone. And if you’re prone to seasonal allergies, you may be more likely to develop a sinus infection. This can cause a runny or stuffy nose, facial pressure, and a sore throat.
Viruses cause most sinus infections. But if it’s thought to be bacterial, your healthcare provider may prescribe an antibiotic to treat it. Two common medications you might receive are Amoxicillin and Augmentin (amoxicillin/clavulanate). They are both first-choice antibiotics for treating a bacterial sinus infection.
Amoxicillin and Augmentin are similar medications. In fact, Augmentin is a combination of two medications — one of which is amoxicillin. So, you may be wondering when one might be recommended over the other. Read on to learn more about amoxicillin versus Augmentin for sinus infections, and which one might be right for you.
What is amoxicillin?
Amoxicillin (Amoxil) is a penicillin antibiotic. It’s been available in the U.S. since the mid-1970s. And it’s FDA-approved to treat infections, including those of the ear, nose, and throat.
Amoxicillin comes as a tablet, capsule, and chewable tablet that you take by mouth. It's available in several dosages. You can also find it as an oral suspension. All forms of amoxicillin are available as lower-cost generics.
Your recommended dosage and how long you take it usually depends on what type of infection you have. For young children, pediatricians will give a dosage based on body weight.
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But amoxicillin isn’t active against all the different strains of bacteria that might cause certain infections. In those cases, your healthcare provider may consider prescribing another antibiotic.
What is Augmentin?
Augmentin is a combination of two different antibiotics — amoxicillin and clavulanate. Clavulanate helps amoxicillin work better against certain bacteria. Augmentin is FDA-approved to treat many different infections, including sinus infections.
Augmentin is also taken orally and is available in several strengths. It comes as a regular and extended-release (XR) tablet, chewable tablet, and oral suspension. All Augmentin formulations are available as lower-cost generics.
As with amoxicillin, your dosage depends on the infection you’re treating. Augmentin covers more bacterial strains than amoxicillin. And it may work against certain bacteria that are resistant to amoxicillin alone.
How do amoxicillin and Augmentin work for sinus infections?
Amoxicillin works for sinus infections by preventing bacteria from creating a cell wall. This takes away the structural support and protection for the bacteria. In turn, the bacteria die. Amoxicillin is also absorbed well by the body, which is why it can attack bacteria in the sinuses.
But some bacteria contain proteins (enzymes) called beta-lactamases. These proteins can inactivate amoxicillin, making it ineffective against bacteria with these proteins. That’s where Augmentin comes in.
Clavulanate is a beta-lactamase inhibitor, which means it blocks beta-lactamases. This allows amoxicillin to work against bacteria that make them. On its own, clavulanate isn’t that effective at killing bacteria. But when combined with amoxicillin in Augmentin, it can treat a wide range of infections.
How are amoxicillin and Augmentin dosed and given?
The typical amoxicillin dosage for a sinus infection is 500 mg every 8 hours, or 875 mg every 12 hours, taken for 5 to 10 days. This may vary based on the severity of your infection. Body weight will determine the dosage for children. You can take amoxicillin with or without food.
The typical Augmentin dosage for a sinus infection is 500 mg/125 mg every 8 hours, or 875 mg/125 mg every 12 hours, taken for 5 to 10 days. Again, body weight will determine the dosage for children. It’s recommended to take Augmentin with food to help your body absorb it and to prevent side effects.
Be sure to take your antibiotic on a regular schedule each day. This helps maintain consistent antimicrobial activity in your body. And that allows the antibiotic to be more effective.
Remember: It’s important to finish the full course of these medications, even if you’re feeling better. If you don’t, the bacteria could become resistant to the antibiotic.
How effective are amoxicillin and Augmentin for treating sinus infections?
Amoxicillin and Augmentin are both first-choice antibiotics for treating most bacterial sinus infections. For initial treatment, these medications work just as well as other antibiotics that cover a broader range of bacteria. Plus, amoxicillin and Augmentin tend to be more affordable. And they can help lessen antibiotic resistance.
But if you’re allergic to penicillin or have certain risk factors (e.g., age, health conditions), other antibiotics may be used first instead.
What are the known side effects of amoxicillin and Augmentin?
Amoxicillin and Augmentin can cause similar side effects. The most common ones include:
Diarrhea
Nausea
Skin rashes
Vomiting
Amoxicillin might also cause anxiety, dizziness, or tooth discoloration (usually in kids). But those occur less often.
Augmentin might also cause headaches, abdominal discomfort, and gassiness in some people.
What are the serious side effects of amoxicillin and Augmentin?
Amoxicillin and Augmentin don’t have very many serious side effects. But there are a few in particular you should know about.
Amoxicillin and Augmentin are both in the same family as penicillin. So, if you’re allergic to penicillin, you may be at risk for a serious allergic reaction. Always remember to alert your healthcare provider about your medication allergies. This helps them recommend the best and safest option for you.
Call 911 if you develop shortness of breath or swelling of the face, tongue, or throat after taking a dose.
Although rare, amoxicillin and Augmentin can cause severe diarrhea. This may be more common with Augmentin. This reaction can be due to a bacterial infection in your gut. Your risk is higher if you’ve been taking several antibiotics, or if you’ve been taking them for a long period of time. Contact your provider right away if you develop severe diarrhea, blood in your stool, or intense abdominal cramps.
What interactions do amoxicillin and Augmentin have?
Examples of medications that may interact with amoxicillin or Augmentin include:
Allopurinol (Zyloprim)
Warfarin (Coumadin, Jantoven)
This may not include all potential interaction with these medications.
Oral contraceptives (birth control pills) have a reputation of interacting with antibiotics. But it hasn’t been proven that they interact with amoxicillin or Augmentin.
Give your healthcare provider and pharmacist your current medication list. That way they can check for potential interactions before starting treatment.
How much do amoxicillin and Augmentin cost?
Amoxicillin and Augmentin are both available as lower-cost generic medications. And you can save even more by using a free GoodRx discount.
Amoxicillin is already inexpensive. But, you can pay as little as $3 at certain pharmacies for a typical 10 days’ supply by using GoodRx. Compared to amoxicillin, Augmentin is more expensive. But you can find a 10 days’ supply of the generic version for as low as $13 at certain pharmacies.
How do healthcare providers decide which medication to prescribe?
Amoxicillin is effective against a narrower range of bacteria than Augmentin. Generally, choosing an antibiotic with the most specific activity against an infection is the best option. This helps prevent antibiotic resistance and unnecessary side effects.
But there are some factors that might lead your healthcare provider to choose Augmentin over amoxicillin. These factors make it more likely to have an infection that’s resistant to amoxicillin alone.
These include:
Age over 65 years old
Compromised immune system
Other health conditions such as diabetes, and heart, kidney, or liver problems
History of recurrent sinus infections
Symptoms of a moderate to severe sinus infection
Having used antibiotics in the past month
A previous antibiotic didn’t work
Close contact with a child in daycare
Smoking cigarettes or having close contact with a smoker
Your provider will recommend the best choice for you based on your medical history, symptoms, and other risk factors.
The bottom line
Amoxicillin and Augmentin are both first-choice options for treating bacterial sinus infections. Like all medications, they can cause side effects, like nausea and diarrhea. And they might interact with some medications. They’re usually taken several times a day for 5 to 10 days.
Augmentin is active against a wider range of bacteria than amoxicillin. Your healthcare provider may recommend it over amoxicillin in certain situations. This is true particularly if you have a moderate to severe infection or if you’re over age 65.
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References
Aring, A. M., et al. (2016). Current concepts in adult acute rhinosinusitis. American Family Physician.
Centers for Disease Control and Prevention. (2019). Sinus infection (sinusitis).
Evans, J., et al. (2021). Amoxicillin clavulanate. StatPearls.
Khanna, N. R., et al. (2021). Beta lactamase inhibitors. StatPearls.
PD-Rx Pharmaceuticals, Inc. (2022). Augmentin [package insert].
Preferred Pharmaceuticals, Inc. (2022). Amoxicillin [package insert].
Rosenfeld, R. M., et al. (2015). Clinical practice guidelines (update): Adult sinusitis. Otolaryngology - Head and Neck Surgery Foundation.
