Augmentin vs. Clindamycin
See how Augmentin and Clindamycin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Augmentin combines amoxicillin with clavulanate to treat a broad range of bacterial infections, including ear, sinus, and urinary tract infections.
Clindamycin is often chosen for patients with penicillin allergies and covers anaerobic bacteria that Augmentin does not reach as reliably.
Both drugs can cause Clostridioides difficile-associated diarrhea, but clindamycin carries an FDA boxed warning for this specific risk.
Augmentin vs. Clindamycin Drug Summary
Augmentin
Augmentin is a penicillin-class antibiotic that combines amoxicillin with clavulanate, a beta-lactamase inhibitor that helps it fight resistant bacteria. It treats infections like ear infections, sinusitis, pneumonia, skin infections, and urinary tract infections. It comes as a tablet, chewable tablet, or oral suspension, usually taken every 8 or 12 hours with food.
Clindamycin
Clindamycin is a lincosamide antibiotic used for serious infections caused by anaerobic bacteria, streptococci, staphylococci, and other susceptible organisms. It treats skin infections, bone and joint infections, gynecological infections, and intra-abdominal infections, and is a common option for people allergic to penicillin. It comes as an oral capsule, IV or IM injection, or topical and vaginal formulation, typically dosed every 6 to 8 hours.
Augmentin vs. Clindamycin Side Effects
Augmentin
Clindamycin
Augmentin vs. Clindamycin Dosage
Augmentin
Clindamycin
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 150 mg every 6 hours | At the start |
| Maximum dose | up to 4800 mg/day IV | If needed |
| Dose changes | 6 increases | As tolerated |
Augmentin
| 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 |
Clindamycin
| STAGE | DOSE | WHEN |
| Starting dose | 150 mg every 6 hours | At the start |
| Maximum dose | up to 4800 mg/day IV | If needed |
| Dose changes | 6 increases | As tolerated |
Augmentin vs. Clindamycin Indications
Augmentin
Augmentin is FDA-approved for common bacterial infections including ear infections, sinusitis, pneumonia, skin infections, and urinary tract infections. Adding clavulanate lets it fight bacteria that would otherwise resist amoxicillin alone by blocking the enzyme that breaks down its beta-lactam ring.
Acute otitis media (ear infections)
Acute bacterial sinusitis
Community-acquired pneumonia (XR)
Skin and skin structure infections
Urinary tract infections
Clindamycin
Clindamycin is FDA-approved for serious infections from anaerobic bacteria as well as certain streptococcal, staphylococcal, and pneumococcal infections. It also treats bone and joint infections, gynecological infections, and intra-abdominal infections, and is a standard alternative for patients who cannot take penicillins.
Serious anaerobic bacterial infections
Skin and skin structure infections
Bone and joint infections
Gynecological infections
Acne vulgaris (topical) and vaginosis (vaginal)
Augmentin vs. Clindamycin Pros and Cons
Augmentin
Augmentin covers a wide range of common outpatient infections and comes in kid-friendly chewable and liquid forms. Its clavulanate component extends coverage to beta-lactamase-producing bacteria, but this also means more gastrointestinal side effects than plain amoxicillin.
Pros
Effective against beta-lactamase-producing bacteria
Available as chewable tablets and pediatric suspension
No FDA boxed warning
Widely used first-line option for common infections
Cons
Cannot be used with a penicillin allergy history
Higher rate of diarrhea than plain amoxicillin
Risk of hepatotoxicity, sometimes severe
Weaker coverage against anaerobic bacteria than clindamycin
Clindamycin
Clindamycin is a go-to option for patients with penicillin allergies and reaches anaerobic bacteria that Augmentin does not cover as well. It comes in oral, IV, topical, and vaginal forms, but carries an FDA boxed warning for C. difficile colitis and does not cross into the central nervous system.
Pros
Safe option for patients allergic to penicillin
Strong coverage against anaerobic bacteria
Available in topical and vaginal forms for acne and vaginosis
Useful in toxoplasmosis and other off-label indications
Cons
FDA boxed warning for C. difficile-associated colitis
Oral capsules can cause esophagitis if not taken with fluids
Does not penetrate the central nervous system, so not for meningitis
Risk of hypersensitivity reactions including SJS and DRESS
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