Augmentin (amoxicillin with clavulanate) is a go-to antibiotic for many infections, but it isn't always the best choice. Maybe you have a penicillin allergy, bad side effects, or the bug is resistant. This page lists common alternatives, when they’re used, and practical tips to help you and your prescriber pick the right option.
Different infections need different drugs. Here are practical swaps often used in clinics:
Upper respiratory / ear infections: Amoxicillin alone can work if resistance isn’t a problem. If penicillin isn’t an option, doctors often use azithromycin or clarithromycin (macrolides) or doxycycline. Macrolides are handy for people allergic to penicillins, but local resistance rates matter.
Skin and soft tissue infections: If the bug is likely staph or strep, cephalexin (a cephalosporin) or dicloxacillin may be used. For true penicillin allergy, doctors may choose a macrolide, doxycycline, or trimethoprim-sulfamethoxazole depending on the suspected bacteria.
Urinary tract infections: Trimethoprim-sulfamethoxazole or nitrofurantoin are common choices. Fluoroquinolones like ciprofloxacin or levofloxacin are effective but used less often now because of side effects and resistance concerns.
Severe or resistant infections: For complicated cases, doctors may pick drugs such as cefuroxime, ceftriaxone, or respiratory fluoroquinolones. These are chosen based on culture results and patient factors.
Start by telling your clinician about allergies, past antibiotic reactions, current medicines, and pregnancy or breastfeeding. These details change the best choice. If possible, get a culture — it narrows the options and reduces guesswork.
Think about safety: macrolides can interact with heart and cholesterol meds, doxycycline shouldn’t be used in young children or pregnant people, and fluoroquinolones carry risks like tendon problems. Also watch for common side effects: diarrhea, yeast infections, and nausea. Finish the full prescribed course unless your prescriber tells you otherwise.
Never use leftover antibiotics, and don’t share them. If you suspect an allergic reaction (hives, swelling, breathing trouble), seek urgent care. For mild side effects, call your provider to see if a switch is safer.
If you want help talking with your doctor, ask for options that match your allergy status and local resistance patterns, and request a culture if the infection is severe or recurring. That makes it more likely you’ll get an effective, safe alternative to Augmentin.
