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

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

Clindamycin

Most common
nausea (up to 5%)
vomiting (up to 3%)
abdominal pain (up to 3%)
pseudomembranous colitis (up to 2%)

Augmentin vs. Clindamycin 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

Clindamycin

Dosage
Dosage Table
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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