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Compare Clindamycin vs. Azithromycin

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

Key takeaways

Clindamycin (Cleocin) and azithromycin (Zithromax) are both antibiotics used to treat bacterial infections, including skin infections and pneumonia. However, they belong to different medication classes: clindamycin is a lincosamide antibiotic, while azithromycin is a macrolide antibiotic. Clindamycin is available in oral capsules, liquid, and injection forms, and is typically taken three to four times a day. In contrast, azithromycin is taken once daily, often for a shorter duration of 3 to 5 days, and is available as tablets and liquid. Both medications are available as a lower-cost generic. Common side effects of clindamycin include diarrhea, nausea, and rash, while azithromycin can cause diarrhea, nausea, and stomach pain. Both medications can lead to serious allergic reactions and *Clostridioides difficile* (C. diff) infections, but azithromycin also carries a risk of heart rhythm problems and liver damage. Clindamycin interacts with medications like warfarin, while azithromycin can interact with warfarin, antiarrhythmics and statins.

Clindamycin (Cleocin)
Azithromycin (Zithromax)
Clindamycin (Cleocin)
Azithromycin (Zithromax)
Summary of Clindamycin vs. Azithromycin
Summary for Lincosamide antibiotic
Prescription only
Clindamycin (Cleocin) is a lincosamide antibiotic that's used to treat many different serious bacterial infections, such as strep throat and skin infections. This antibiotic is approved for use in both adults and children. Clindamycin (Cleocin) is available as a capsule and liquid that are taken 3 or 4 times per day, depending on your age and your infection. It's also available as an injection that's given by a healthcare professional. Side effects include stomach upset, itching, and rash.
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.
Indications of Clindamycin vs. Azithromycin
Indications for

•Skin infections (e.g., cellulitis)

•Lower respiratory tract infections (e.g., pneumonia, bronchitis)

•Stomach infections

•Pelvic and genital tract infections

•Bloodstream infections

•Bone and joint infections - injection form only

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)
Pros and Cons of Clindamycin vs. Azithromycin
Pros and Const for Lincosamide antibiotic
Pros

•Can treat many different infections throughout the body

•Available as lower-cost generic capsule, liquid, and injection

•Can take if you have a penicillin allergy

Cons

•Might need to take three or four times per day

•Must take capsules with a full glass of water to prevent irritation to your esophagus (the tube that connects your throat to your stomach)

•Risk of causing a type of infectious diarrhea

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)
Common Side Effects of Clindamycin vs. Azithromycin
Common Side Effects for

•Diarrhea

•Nausea

•Vomiting

•Stomach pain

•Skin rash

•Itching

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%)
Warnings of Clindamycin vs. Azithromycin
Common Side Effects for

•Severe allergic reactions and skin reactions

•Diarrhea from Clostridioides difficile infection

•Development of drug-resistant bacteria

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
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Compare Clindamycin vs. Azithromycin

Key takeaways

Summary of Clindamycin vs. Azithromycin

Indications of Clindamycin vs. Azithromycin

Pros and Cons of Clindamycin vs. Azithromycin

Common Side Effects of Clindamycin vs. Azithromycin

Warnings of Clindamycin vs. Azithromycin

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