Amoxicillin (Amoxil) alternatives: What can I take instead of amoxicillin?

Amoxicillin doesn't work for everyone. Augmentin, cephalexin, cefdinir, Zithromax, and Vibramycin are some amoxicillin alternatives. Get the full list here.

By Chad Shaffer, MD | Feb. 7, 2023

Looking for an alternative to amoxicillin has always been necessary at times due to drug allergy or ineffectiveness. Still, in late 2022, the need reached a fever pitch due to the shortage of antibiotics. The oral powder form of amoxicillin, used by pharmacists in making liquid amoxicillin, went on the Food and Administration (FDA) drug shortage list in November 2022. As one of the most common prescriptions in the nation, the news was particularly troubling entering the winter season, when there is increased demand for liquid amoxicillin due to childhood sinus and ear infections. Thankfully, if weight-based dosing worked out, amoxicillin chewable tablets could be used instead, or capsules could be opened and poured on applesauce, according to the American Academy of Pediatrics. Dosing guidelines do not always allow for tablets or capsules of the drug to work out, so it is helpful to know that other antibiotics can usually be substituted for amoxicillin. We will introduce you to the common alternatives.

What can I take in place of amoxicillin (Amoxil)?

Amoxicillin belongs to the penicillin class of antibiotics. Other class members could be considered if amoxicillin is unavailable. The class has had a long and celebrated role in medicine, but it is a class many people cannot use due to a possible allergy. Cephalosporin antibiotics may be an option in these cases if the reaction is only a rash. Although cephalosporins and penicillins have a beta-lactam chemical structure, the forms are sufficiently different to allow cephalosporin use in some with penicillin allergies. With a history of more severe penicillin-allergic reactions, a different antibiotic class could be turned to, such as a member of the sulfonimide, macrolide, tetracycline, or quinolone groups.

These other antibiotics could also be called upon if bacterial resistance to penicillins is a concern, a not uncommon problem due to beta-lactamase enzyme production by bacteria. In fact, amoxicillin is combined with clavulanic acid, a beta-lactamase inhibitor, to make Augmentin-resistant bacteria. The details of this antibiotic and other alternatives to amoxicillin are important to know.

Compare Amoxil (amoxicillin) alternatives
Drug name	Uses	Dosage	Savings options
Amoxicillin	Bacterial infections, streptococcal pharyngitis (strep throat), acute otitis media (ear infection), acute bacterial sinusitis, community-acquired pneumonia, Helicobacter pylori infection (H. pylori), Lyme disease (off-label)	500 to 1000 mg every 8 to 12 hours depending on indication in adults (dosing for pediatric patients is dependent on age, weight, and indication)	Amoxicillin coupons
Augmentin (amoxicillin-clavulanic acid)	Bacterial infections, acute bacterial sinusitis, urinary tract infection, community-acquired pneumonia	500 mg/125 mg to 875 mg/125 mg every 8 to 12 hours depending on indication	Augmentin coupons
Penicillin V Potassium	Bacterial infections, streptococcal pharyngitis, rheumatic fever prophylaxis	125 to 500 mg every 6 to 12 hours, depending on the indication	Penicillin V Potassium coupons
Cephalexin	Bacterial infections, streptococcal pharyngitis, urinary tract infection, skin, and soft tissue infection	250 to 500 mg every 6 to 12 hours, depending on the indication	Cephalexin coupons
Cefuroxime axetil	Bacterial infections, streptococcal pharyngitis, acute bacterial sinusitis, Lyme disease	250 to 500 mg twice daily	Cefuroxime coupons
Cefdinir	Bacterial infections, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia	300 mg every 12 hours	Cefdinir coupons
Suprax (cefixime)	Bacterial infections, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia, urinary tract infection, gonococcal infection	400 mg once daily or 800 mg once for uncomplicated gonococcal infection	Suprax coupons
Ceftriaxone sodium	Bacterial infections, bacterial meningitis, community-acquired pneumonia, gonococcal infection, urinary tract infection, pelvic inflammatory disease (PID)	1 to 2 g intramuscular injection or intravenous every 12 to 24 hours, depending on the indication	Ceftriaxone sodium coupons
Bactrim DS (sulfamethoxazole-trimethoprim)	Bacterial infections, urinary tract infections, pneumocystis carinii	800 mg/160 mg twice daily, depending on the indication	Bactrim DS coupons
Zithromax (azithromycin)	Bacterial infections, streptococcal pharyngitis, acute bacterial exacerbation of COPD, community-acquired pneumonia, chlamydia infection, PID, chancroid, mycobacterium avium complex	250 to 500 mg once daily, depending on the indication	Zithromax coupons
Clarithromycin	Bacterial infections, streptococcal pharyngitis, acute bacterial exacerbation of chronic bronchitis, community-acquired pneumonia, chlamydia infection, PID, chancroid, mycobacterium avium complex, H. pylori infection	250 to 500 mg twice daily	Clarithromycin coupons
Vibramycin (doxycycline hyclate)	Bacterial infections, acute bacterial sinusitis, community-acquired pneumonia, chlamydia infection, acne vulgaris, syphilis, lymphogranuloma venereum, anthrax, Rocky Mountain Spotted Fever, tularemia, brucellosis, cholera, malaria prophylaxis, Lyme disease (off-label)	100 mg twice daily	Vibramycin coupons
Levofloxacin	Pneumonia, prostatitis, urinary tract infection, skin and soft tissue infection, acute bacterial exacerbation of chronic bronchitis, acute bacterial sinusitis, plague, anthrax	250 to 750 mg once daily	Levofloxacin coupons
Cipro (ciprofloxacin)	Bacterial infections, prostatitis, urinary tract infection, bone and joint infection, intra-abdominal infection, hospital-acquired pneumonia, typhoid, plague, anthrax	250 to 750 mg every 12 hours	Cipro coupons
Cleocin (clindamycin)	Bacterial infections, streptococcal pharyngitis, bacterial vaginosis	150 to 450 mg every 6 to 12 hours, depending on the indication	Cleocin coupons

Other alternatives to amoxicillin

Top 5 amoxicillin alternatives

The following are some of the most common alternatives to amoxicillin.

1. Augmentin

If an amoxicillin shortage has you looking for another option, Augmentin (amoxicillin-clavulanate) makes a lot of sense, since this product contains amoxicillin along with clavulanate and is available in liquid and tablet forms. Adding the beta-lactamase inhibitor clavulanate fends off certain bacteria that would be resistant to plain amoxicillin. The enhanced action works for many ear, sinus, and lung infections cases. The downside of having more antibiotic power is a tendency for more adverse effects like diarrhea.

2. Cephalexin

If you have a history of a minor rash with prior amoxicillin use, cephalexin might make a good substitute. It is a first-generation cephalosporin. Cephalexin is a common pick for strep throat and skin infections like cellulitis.

3. Cefdinir

Advancing to a third-generation like cefdinir can provide you with a broader spectrum of antibiotic action. Accordingly, cefdinir can be chosen for acute otitis media and pneumonia, even when amoxicillin has been ineffective. Ceftriaxone is an injectable third-generation cephalosporin that can be administered in the doctor’s office. These agents can also be effective for urinary tract infections, a condition for which amoxicillin is not often chosen. The once-daily dosing of cefdinir is nice as well. Unfortunately, killing more bacteria means eradicating more good bacteria from the intestinal tract, and therefore, healthcare providers typically recommend not using a more potent antibiotic than is necessary. The quinolone antibiotic levofloxacin is a good example of a powerful antibiotic that is usually avoided if other options will work.

4. Zithromax

Zithromax (azithromycin) has been a popular pick for strep throat and respiratory tract infectious diseases for those who are allergic to penicillin. The macrolide drug’s once-daily dosing and five-day treatment course have won it plenty of fans. Unfortunately, more recently, bacterial resistance rates to macrolides have tempered the enthusiasm, so Zithromax is not a recommended first choice for most folks with acute bacterial sinusitis or acute otitis media.

5. Vibramycin

Sinusitis, pneumonia, and Lyme disease are all in the wheelhouse of Vibramycin, the brand name of doxycycline. These uses make this tetracycline antibiotic an option in many cases where amoxicillin cannot be used or is ineffective. The downsides of tetracyclines are worth noting. Stomach upset, and sun sensitivity can be significant, and young children fear dental staining with long treatment courses.

Natural alternatives to amoxicillin

When you truly have a bacterial infection and need amoxicillin, it is unlikely that your healthcare provider’s medical advice would be to use a natural alternative. The more pertinent question is if you have a bacterial infection. Many sinus and ear infections are caused by viruses unaffected by antibiotics. The healthcare professional evaluating you will likely take into account infection factors like severity and timeframe and patient factors like your age and health history to help determine if antibiotics are needed. This determination can be difficult, but it is critically important not to unnecessarily expose you to antibiotic side effects.

How to switch to an amoxicillin (Amoxil) alternative

Finding an alternative to amoxicillin is quite possible whether you need a different option due to a drug shortage, allergy, ineffectiveness, or cost. The selection process must consider what bacteria is likely to be causing the infection and what antibiotic is strong enough to get the job done without being excessive. Your clinicians will want to cross-reference your list of prescription medications, over-the-counter drugs, and supplements to look for drug interactions. When it is all said and done, you can expect to be set up with a different antibiotic and be on your way to feeling better.