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Compare Azithromycin vs. Cephalexin

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Azithromycin (Zithromax) and cephalexin (Keflex) are both antibiotics used to treat bacterial infections, but they belong to different medication classes. Azithromycin is a macrolide antibiotic, while cephalexin is a cephalosporin antibiotic. Both medications can treat respiratory and skin infections, but azithromycin is also used for conditions like pneumonia, bronchitis, and certain sexually transmitted infections, while cephalexin is used for urinary tract infections and bone infections. Azithromycin is typically taken once daily for 3 to 5 days, whereas cephalexin is taken 2 to 4 times per day for 7 to 14 days. Both medications are available as lower-cost generics and come in liquid forms for those who have trouble swallowing pills. Common side effects for both include diarrhea and stomach pain, but azithromycin can also cause nausea, and cephalexin can cause vomiting and indigestion. Azithromycin has potential interactions with antiarrhythmics and statins, while cephalexin can interact with metformin and probenecid. It's important to take each medication exactly as prescribed to avoid resistance and ensure effectiveness.

  • Azithromycin (Zithromax)
    Cephalexin
  • Azithromycin (Zithromax)
    Cephalexin

  • Summary of Azithromycin vs. Cephalexin

    Summary for Macrolide antibiotic
    Prescription only

    Azithromycin (Zithromax) is a macrolide antibiotic. It's used to treat many types of infections in children and adults, including strep throat, sinus infection, and pneumonia. Azithromycin (Zithromax) is taken by mouth once daily. Typically, the length of treatment ranges from 3 to 5 days, depending on the type of infection you have. For convenience, azithromycin (Zithromax) also comes pre-packaged as Z-Pak. Some of the more common side effects of azithromycin (Zithromax) include diarrhea, stomach pain, and nausea.

    Summary for Cephalosporin antibiotic
    Prescription only

    Cephalexin is a common antibiotic that's used to treat many different bacterial infections including urinary tract infections (UTIs), ear infections, and sinus infections, to name a few. Cephalexin is a cephalosporin antibiotic that kills bacteria to fight the infection. It's safe to use in people over the age of 1, and it's typically taken by mouth 2 to 4 times per day. This medication is available as a lower-cost generic capsule, tablet, and suspension; the brand name Keflex is no longer available. Side effects can include nausea, vomiting, and diarrhea.

  • Indications of Azithromycin vs. Cephalexin

    Indications for

    Adults

    Azithromycin (Zithromax) can treat certain types of:

    •Sudden worsening of chronic obstructive pulmonary disease (COPD) from a bacterial infection
    •Bronchitis
    •Sinus infections
    •Pneumonia
    •Strep throat
    •Tonsil infections
    •Skin infections (e.g., cellulitis)
    •Urethra or cervix infections
    •Genital ulcer disease (chancroid)

    Children

    Azithromycin (Zithromax) can treat certain types of:

    •Ear infections (ages 6 months and older)
    •Pneumonia (ages 6 months and older)
    •Strep throat (ages 2 years and older)
    •Tonsil infections (ages 2 years and older)
    Indications for
    •Respiratory tract infections
    •Ear infections
    •Skin infections
    •Bone infections
    •Urinary tract infections (UTIs)
    •Reproductive system infections

  • Pros and Cons of Azithromycin vs. Cephalexin

    Pros and Const for Macrolide antibiotic
    Pros
    •Taken by mouth once daily
    •Treatment typically lasts only 3 to 5 days
    •Comes as a liquid; good option for people who've trouble swallowing tablets
    •Available as a lower-cost generic
    Cons
    •Might not be the best choice for people with severe liver problems or certain heart problems
    •Can cause stomach-related side effects, like diarrhea and stomach pain
    •Some bugs might be resistant to azithromycin (Zithromax)
    Pros and Const for Cephalosporin antibiotic
    Pros
    •Treats several common types of bacterial infections
    •Can use for adults and children over the age of 1
    •Available as a liquid for people who have trouble swallowing pills
    •Available as a lower-cost generic
    Cons
    •Usually need to take a few times per day
    •Might not be able to take if you're allergic to penicillins or other cephalosporin antibiotics
    •Not recommended for the cold or flu (these are viral illnesses, not bacterial infections)

  • Common Side Effects of Azithromycin vs. Cephalexin

    Common Side Effects for

    Adults

    •Diarrhea (4-5%)
    •Nausea (3%)
    •Stomach pain (2-3%)

    Children

    •Diarrhea (2-6%)
    •Vomiting (1-6%)
    •Stomach pain (1-3%)
    Common Side Effects for
    •Diarrhea
    •Nausea
    •Vomiting
    •Indigestion
    •Stomach pain

  • Warnings of Azithromycin vs. Cephalexin

    Common Side Effects for
    •Severe allergic and skin reactions
    •Liver damage
    •Heart rhythm problems (QT prolongation)
    •Possible higher risk of death from heart problems
    •Diarrhea from Clostridioides difficile infection
    •Worsening of certain muscle problems (myasthenia gravis)
    •Doesn't treat syphilis
    Common Side Effects for
    •Allergic reactions
    •Diarrhea from Clostridioides difficile infection
    •Development of drug-resistant bacteria
    •Seizures
    •Higher risk of bleeding

  • Prices with our coupons for Azithromycin vs. Cephalexin

    Learn more about Azithromycin
    Learn more about Cephalexin

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