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Tobramycin vs. Azithromycin

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

Key takeaways

Tobramycin (generic name) and Azithromycin (brand name Zithromax) are both antibiotics, but they belong to different classes and are used in different ways. Tobramycin is an aminoglycoside antibiotic given by injection, typically in a hospital or healthcare setting, and is used to treat severe infections like sepsis, pneumonia, and meningitis. It requires close monitoring due to potential serious side effects like hearing loss and kidney damage. On the other hand, Azithromycin is a macrolide antibiotic taken orally or by injection, often as a convenient Z-Pak, and is used to treat infections such as strep throat, sinus infections, and pneumonia. Azithromycin is generally taken once daily for a shorter duration (3 to 5 days) and is available in tablet, liquid, and injectable forms. While both medications can cause diarrhea and other gastrointestinal issues, Azithromycin also carries risks for heart rhythm problems and liver damage. Tobramycin is more likely to be used in a controlled medical environment due to its administration method.

Tobramycin

(Tobi)

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Azithromycin

(Zithromax)

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Summary for Tobramycin

Prescription only

Tobramycin (Tobi) helps people with cystic fibrosis (CF) breathe better by controlling their Pseudomonas aeruginosa bacterial infection long term. It's inhaled through your mouth using a device (either a nebulizer or inhaler), and it can cause irritation in the mouth, throat, and lungs.

Indications for Tobramycin

  • Cystic fibrosis (CF) with Pseudomonas aeruginosa bacterial infection

Pros and Cons for Tobramycin

Pros

  • Works directly in the area where the bacterial infection is
  • Fewer serious side effects than oral or intravenous (IV) antibiotics
  • Can be given to children older than 6 years of age

Cons

  • Requires correct inhalation technique to get the full effect
  • Can cause hearing loss, so you may need regular hearing tests
  • Need to remember to start and stop taking the medication every 28 days

Common Side Effects for Tobramycin

  • Lung reactions, including cough, shortness of breath, wheezing, "rattling" lung sounds
  • Hoarseness
  • Mouth or throat pain

Warnings for Tobramycin

  • Difficulty breathing
  • Hearing loss
  • Kidney injury
  • Muscle weakness
  • Harm to unborn baby

Summary for Azithromycin

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 for Azithromycin

Adults

Azithromycin (Zithromax) can treat certain types of:

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 for Azithromycin

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 for Azithromycin

Adults

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

Children

  • Diarrhea (2-6%)
  • Vomiting (1-6%)
  • Stomach pain (1-3%)

Warnings for Azithromycin

  • 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 Tobramycin vs. Azithromycin

Price Card Drug Icon
Tobramycin1 eye dropper / 5ml of 0.3%
$8.97$23.98
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Azithromycin1 z-pak / 6 tablets of 250mg
$9.38$23.26
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