Is Augmentin Better Than Amoxicillin?

Amoxicillin capsules. Tek Image/Science Photo Library/Getty Images

If you have ever been prescribed antibiotics for a bacterial infection, you have probably been given amoxicillin or Augmentin. Or if you are a parent and your child has ever needed to take antibiotics, she has likely taken one of both of them as well. Have you ever wondered why you were prescribed one or the other?

Many people believe that they are given Augmentin because it is stronger than amoxicillin.

But it turns out it's really not that simple.

Amoxicillin

Amoxicillin is often the first antibiotic that is prescribed for common infections like ear infections and strep throat. It's used in young children because it is typically effective against the bacteria that causes common childhood infections and it doesn't have many severe side effects.

Amoxicillin is effective against both gram-positive and gram-negative bacteria. It kills similar bacteria but it less effective than penicillin against streptococcus pneumococcus (a type of bacteria that causes infections like pneumonia, meningitis, bacteremia [blood infection], ear infections and sinus infections).

Amoxicillin is commonly used to treat:

  • Ear, Nose and Throat Infections
  • Urinary Tract Infections
  • Skin Infections
  • Tonsillitis
  • Lower Respiratory Tract Infections (such as pneumonia)
  • H. pylori
  • Anthrax
  • Infective Endocarditis
  • Lyme Disease
  • Chlamydia

Augmentin

Augmentin is amoxicillin combined with clavulanate, a β-lactamase blocker.

Amoxicillin binds to penicillin-binding proteins, while the addition of the beta-lactamase blocker broadens the spectrum of bacteria that can be inhibited.

In words that make sense to the everyday person, this extra ingredient added to amoxicillin allows the antibiotic to kill more types of bacteria than taking "regular" amoxicillin.

Augmentin is approved to treat infections such as:

  • Lower Respiratory Infections (such as pneumonia)
  • COPD
  • Sinus Infections
  • Ear Infections
  • Human/Animal Bite Wounds
  • Erysipelas
  • Pyelonephritis (Kidney Infections)
  • Skin Abscess
  • Diabetic Foot
  • Chronic Strep carriers

The most common side effect of augmentin is diarrhea. Some people may also experience nausea, vomiting, yeast infections, rash, diaper rash, and loose stools. Severe reactions like anaphylaxis should be reported to your healthcare provider.

What Are Gram Negative and Gram Positive Bacteria?

Bacteria are classified as gram-negative or gram-positive based on how they look under a microscope when stained with a solution called a gram stain. Gram-negative bacteria appear pink or red under a gram stain and gram-positive bacteria appear purple. These color changes occur based on the type of the bacteria's cell wall.

Gram negative and gram positive bacteria respond to antibiotics in different ways. One type of antibiotic may be needed to treat a certain type of bacteria if it is gram positive and a different type may be needed to treat a gram negative bacteria. Some broad spectrum antibiotics may treat both gram positive and gram negative bacteria.

Why Not Use the Antibiotic That Kills the Most Bacteria?

If you have an infection and don't necessarily know which bacteria is causing it, it seems like it would make sense to use an antibiotic that would kill the most bugs.

However, doing that can cause major problems. The antibiotics can end up killing "good bacteria" that exists in your body all of the time. Changing the balance of which bacteria are in your body that are supposed to exist there can allow "bad bacteria" to take over and cause further infections or problems.

Another even more pressing concern is that using broad spectrum antibiotics can lead to antibiotic resistance. If you don't know much about antibiotic resistance, you need to. It's a major threat to our world and has been called one of the greatest public health threats of our time. Due to misuse and overuse of antibiotics, bacteria have developed defense mechanisms to many of the drugs we currently use to kill them.

The more exposure a bacteria has to an antibiotic, the more likely it is to be able to get stronger and develop the ability to overcome it. Which means the antibiotics we have now could essentially become useless in the future.

Using an antibiotic that is as "narrow spectrum" as possible is better for everyone. It will kill the infection that is making you sick and is less likely to allow other bacteria in your body to develop resistance to antibiotics that might normally be used to kill them. Broad spectrum antibiotics may also cause more side effects. If your doctor is able to identify the organism that is causing your illness and find out which antibiotics are most effective at killing it, that is ideal. Otherwise, using the most narrow spectrum antibiotic that will treat the most likely cause of your infection is the way to go.

Clearly, these decisions are made by your health care provider, not by you, when you are sick. However, you can help take charge of your health and reduce the risk of antibiotic resistance by asking your doctor certain questions. Ask things such as:

  • Is this the best antibiotic to treat my infection?
  • Do we know what bacteria is making me sick?
  • Do I really need an antibiotic or could this infection get better on its own?

Make sure you understand what medicine you are taking and why. If you are prescribed an antibiotic, take it exactly as prescribed. Even if you start to feel better, don't stop taking it until you have completed the course that your health care provider discussed with you. Stopping the medicine too early can allow the bacteria to get stronger, develop resistance, and come back.

A Word From Verywell

Whether you get a prescription for amoxicillin, Augmentin, or a different antibiotic, make sure you know what you are taking it for and how it will work to treat your infection. Don't push your physician for antibiotics if they aren't necessary and make sure you follow the instructions for taking them if they are. Antibiotics work to kill specific types of bacteria, so there really isn't such a thing as "stronger" or "weaker" when it comes to these medications.

Many people are surprised to be given amoxicillin when they have a serious infection such as pneumonia, a skin abscess or even endocarditis (an infection in the heart) but if it kills the bacteria that is causing the infection, it's the right medicine for the job. As you can see on the lists above, there is some overlap regarding the infections these antibiotics treat. So if you have a sinus infection that doesn't get better when you take amoxicillin, your physician may try Augmentin next. It covers additional bacteria but that doesn't make it "stronger". It doesn't mean the amoxicillin didn't work because it wasn't strong enough. It just means your infection is most likely caused by a bacteria that wasn't susceptible to amoxicillin.

Choosing the right antibiotic isn't always easy. If you ask questions and try to understand what medicine you have been given and why, you are more likely to take it correctly and, hopefully, get better as quickly as possible. As you can see, antibiotics don't fall under the "more is better" category. We used to think that it didn't hurt to take them even if we didn't know whether an illness was caused by a virus, bacteria, or something else. Now we know that couldn't be farther from the truth. Take your antibiotics when you need them, but avoid them if you don't.

Sources:

Amoxil, Moxatag (amoxicillin) dosing, indications, interactions, adverse effects, and more. http://reference.medscape.com/drug/amoxil-moxatag-amoxicillin-342473. 

Augmentin, Augmentin XR (amoxacillin/clavulanate) dosing, indications, interactions, adverse effects, and more. http://reference.medscape.com/drug/augmentin-amoxicillin-clavulanate-342474#10. 

Gram-negative Bacteria | NIH: National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/research/gram-negative-bacteria. 

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