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Compare Levofloxacin vs. Azithromycin

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

Key takeaways

Levofloxacin and Azithromycin (Zithromax) are both antibiotics used to treat bacterial infections, including pneumonia and sinus infections. However, they belong to different medication classes: levofloxacin is a fluoroquinolone antibiotic, while azithromycin is a macrolide antibiotic. Levofloxacin is typically used for more serious infections due to its potential for severe side effects, such as tendon rupture and nerve damage, and is usually taken once daily. In contrast, azithromycin is often taken for a shorter duration, typically 3 to 5 days, and is available in a convenient Z-Pak form. Levofloxacin is available only as a generic, while azithromycin is available as both a brand and generic. Common side effects of levofloxacin include nausea, headache, and diarrhea, whereas azithromycin may cause diarrhea, nausea, and stomach pain. Both medications can cause QT prolongation, a serious heart rhythm problem, but azithromycin also has a rare risk of increasing heart-related death. Levofloxacin interacts with antacids and multivitamins, while azithromycin can interact with antiarrhythmics and statins.

  • Levofloxacin
    Azithromycin (Zithromax)
  • Levofloxacin
    Azithromycin (Zithromax)

  • Summary of Levofloxacin vs. Azithromycin

    Summary for Fluoroquinolone antibiotic
    Prescription only

    Levofloxacin is a fluoroquinolone antibiotic. It can treat many types of bacterial infections, including pneumonia and urinary tract infections (UTIs). But because levofloxacin can cause serious side effects, such as tendon rupture and nerve damage, it's usually only prescribed for more serious infections or when safer options aren't available. Levofloxacin is taken by mouth, typically once daily. Some of the more common side effects of this medication include nausea, headache, and diarrhea. Levofloxacin is generic only, brand-name Levaquin is no longer available.

    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 Levofloxacin vs. Azithromycin

    Indications for

    Adults only

    •Skin infections
    •Sinus infections
    •Pneumonia
    •Sudden worsening of chronic (long-term) bronchitis
    •Urinary tract infections (UTIs)
    •Kidney infections
    •Long-term prostate infections

    Adults and children

    •Anthrax exposure through inhalation
    •Plague
    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 Levofloxacin vs. Azithromycin

    Pros and Const for Fluoroquinolone antibiotic
    Pros
    •Usually taken once per day
    •Available as tablets, oral liquid, and injection
    •Available as a lower-cost generic
    Cons
    •Has many potentially serious side effects and risks (e.g, nerve issues, irregular heartbeat)
    •Might cause muscle, bone, and joint problems in children
    •Interacts with some antacids and multivitamins
    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 Levofloxacin vs. Azithromycin

    Common Side Effects for
    •Nausea (7%)
    •Headache (6%)
    •Diarrhea (5%)
    •Trouble sleeping (4%)
    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 Levofloxacin vs. Azithromycin

    Common Side Effects for
    •Tendon inflammation and rupture
    •Effects on the brain, nerves, and mental health
    •Worsening of myasthenia gravis
    •Severe allergic and skin reactions
    •Liver damage
    •Severe blood vessel (aorta) damage
    •Diarrhea from Clostridioides difficile infection
    •Life-threatening abnormal heart rhythm (QT prolongation)
    •Muscle, bone, and joint problems in children
    •Sun and light sensitivity
    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

  • Prices with our coupons for Levofloxacin vs. Azithromycin

    Learn more about Levofloxacin
    Learn more about Azithromycin

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