Augmentin vs. Bactrim

See how Augmentin and Bactrim compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Augmentin and Bactrim treat mostly different infections, so the right choice depends on the specific bacteria being targeted, not personal preference.

  • Augmentin is a penicillin-based antibiotic while Bactrim is a sulfa-based combination, so someone allergic to one may still be able to take the other.

  • Bactrim is far less expensive than Augmentin but carries a higher risk of severe skin reactions and cannot be used in pregnancy or very young infants.

Augmentin vs. Bactrim Drug Summary

Augmentin

Augmentin combines amoxicillin, a penicillin antibiotic, with clavulanate, which blocks the bacterial enzymes that would otherwise destroy amoxicillin. It treats common infections like sinusitis, ear infections, pneumonia, and urinary tract infections. It is taken by mouth every 8 or 12 hours depending on the strength prescribed.

Bactrim

Bactrim combines sulfamethoxazole and trimethoprim, two drugs that block sequential steps in bacterial folate production. It treats urinary tract infections, traveler's diarrhea, and Pneumocystis pneumonia, and is also used off-label for MRSA skin infections. It is taken by mouth, usually twice a day.

Augmentin vs. Bactrim Side Effects

Augmentin

Most common
nausea (up to 3%)
vomiting (up to 1%)
diarrhea/loose stools (up to 9%)
skin rash/urticaria (up to 3%)

Bactrim

Most common
nausea (rate not quantified)
vomiting (rate not quantified)
rash (rate not quantified)
anorexia (rate not quantified)

Augmentin vs. Bactrim Dosage

Augmentin

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 250 mg/125 mg every 8 hrs At the start
Maximum dose 2000 mg/125 mg every 12 hrs If needed
Dose changes 4 increases As tolerated

Bactrim

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 800 mg/160 mg every 12h At the start
Maximum dose 8-10 mg/kg/day q6-12h If needed
Dose changes 3 increases As tolerated

Augmentin vs. Bactrim Indications

Augmentin

Augmentin is FDA-approved for common bacterial infections including sinusitis, ear infections, pneumonia, urinary tract infections, and skin infections. It works against many bacteria that have become resistant to plain amoxicillin because clavulanate disables the enzyme they use to survive. It should not be used by anyone with a history of penicillin anaphylaxis.

  • Lower respiratory tract infections

  • Acute bacterial otitis media

  • Acute bacterial sinusitis

  • Skin and skin structure infections

  • Urinary tract infections

Bactrim

Bactrim is FDA-approved for urinary tract infections, traveler's diarrhea, shigellosis, and Pneumocystis pneumonia, often in patients with HIV or other immune conditions. It is also used off-label for MRSA skin infections, though this is not an FDA-approved use. It should be avoided in infants under two months old and during pregnancy.

  • Pneumocystis jirovecii pneumonia

  • Acute otitis media in children

  • Urinary tract infections

  • Shigellosis

  • Traveler's diarrhea

Augmentin vs. Bactrim Pros and Cons

Augmentin

Augmentin covers a broad range of common bacterial infections and is generally well tolerated, with gastrointestinal upset being the main complaint. It costs more out of pocket than Bactrim and carries a small risk of liver-related side effects that Bactrim does not share.

Pros

  • Effective against beta-lactamase-producing bacteria

  • Available as chewable tablets for children

  • No boxed warning for severe skin reactions

  • Considered safe during pregnancy in most cases

Cons

  • Not an option for people with penicillin allergy

  • Higher list price, roughly $80 to $150 a month without insurance

  • Can cause hepatotoxicity in rare cases

  • Taken 2 to 3 times daily depending on strength

Bactrim

Bactrim is one of the least expensive commonly prescribed antibiotics and covers infections Augmentin does not treat, including Pneumocystis pneumonia. It carries a higher risk of serious skin reactions and is not an option during pregnancy or in very young infants.

Pros

  • Much lower list price, roughly $10 to $30 a month without insurance

  • Covers Pneumocystis pneumonia, which Augmentin does not treat

  • Taken just twice a day

  • Useful off-label for MRSA skin infections

Cons

  • Risk of Stevens-Johnson syndrome and toxic epidermal necrolysis

  • Contraindicated in infants under 2 months old

  • Not safe during pregnancy or breastfeeding

  • Risk of hemolytic anemia in G6PD-deficient patients

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