Is Augmentin Better Than Amoxicillin?

Choosing the Right Antibiotic for an Infection

If you or your child has ever needed to take an antibiotic for a bacterial infection, there's a good chance the medication prescribed was either amoxicillin or Augmentin (amoxicillin clavulanate).

A common assumption about these two medications is that Augmentin is simply a stronger version of amoxicillin but that isn't quite accurate. Augmentin contains a second active ingredient, which makes it more appropriate for treating certain infections than others.

The same holds true for amoxicillin and, to make the distinctions between the drugs even hazier, there are a few infections that both treat equally effectively. Ultimately, the antibiotic a doctor prescribes will depend on the type of illness being treated and the bacteria responsible for it.

Amoxicillin

Amoxicillin is often the first antibiotic prescribed for common bacterial infections, particularly those that cause illness in children, such as ear, nose, and throat infections, including tonsillitis.

This antibiotic also is the first drug of choice for:

(Note that although amoxicillin can kill many of the same bacteria as penicillin, it is less effective than penicillin against Streptococcus pneumococcus, the bacteria commonly associated with meningitis and systemic bacteremia.)

The side effects of amoxicillin tend to be relatively mild, which is another reason it's often prescribed for kids. The most common ones include rash, vaginal itching, and a dark or "hairy tongue.Digestive side effects such as nausea and vomiting can occur, but are much more common with Augmentin.

As with penicillin, there is a risk of an allergic reaction to amoxicillin in those predisposed to it. Symptoms include rash, itching, swelling of the face, tongue, and/or throat, trouble breathing, and dizziness. These can be life-threatening. It's vital a doctor take a medical history before prescribing amoxicillin to determine if a patient has a known history of allergy to antibiotics.

Augmentin

Augmentin is amoxicillin combined with a beta-lactamase inhibitor called clavulanate, an ingredient that blocks the enzymes that contribute to antibiotic resistance.

The addition of a beta-lactamase blocker to amoxicillin allows Augmentin to overcome resistance to harder-to-treat bacteria, broadening the spectrum of infections it can treat. It is for this reason that Augmentin is referred to as a broad-spectrum antibiotic.

Augmentin can treat the same bacteria as amoxicillin, but also is effective against certain harder-to-treat infections, including:

It should be noted there are a few infections for which amoxicillin and Augmentin are prescribed equally:

  • Pyelonephritis (kidney infections)
  • Erysipelas, a type of skin infection
  • Chronic strep "carriers"

The most common side effect of Augmentin is diarrhea. Some people may also experience nausea, vomiting, yeast infections, and rash.

Choosing the Right Antibiotic

If you have an infection and don't necessarily know which bacteria is causing it, it may seem to make sense to use an antibiotic that would kill the most bugs. However, doing that can cause major problems.

Antibiotics used indiscriminately may destroy "good" bacteria along with "bad," thereby altering the body's natural flora and allowing even worse bacteria to proliferate.

Another, even more pressing concern is that using broad spectrum antibiotics can lead to antibiotic resistance. Resistance develops when an antibiotic you are using are unable to fully eradicate a bacteria in your body, often because you stopped treatment before you were supposed to.

When this happens, a few mutated bacteria may survive, some of which may be naturally resistant to the antibiotic you were taking. Because you didn't "hit the infection hard enough," these survivors now have the opportunity to multiply and become the dominant strain. As such, the next time you develop an infection, the antibiotic will not work anywhere near as well.

If this happens with broad-spectrum antibiotic like Augmentin, you will be at greater risk of having multiple types of drug resistance. With a "narrow-spectrum" antibiotic like amoxicillin, the consequence may be less severe.

How to avoid antibiotic resistance
Illustration by JR Bee, Verywell

How to Avoid Antibiotic Resistance

  • Always take an antibiotic as prescribed.
  • Complete the entire course even if you feel better.
  • Do not save antibiotics for future use.
  • Do not use someone else's antibiotics.
  • Do not take antibiotics for a viral infection.
  • Avoid overuse. Take an antibiotic only if your doctor deems it necessary.

A Word From Verywell

Whether you're prescribed amoxicillin, Augmentin, or another antibiotic, it's not so much the "strength" of the drug you should be concerned about; it's all about the safety, efficacy, and appropriateness of treatment.

People are sometimes surprised, and even taken aback, when they are given amoxicillin for a serious infection such as pneumonia. But in many cases that may be all that is needed to resolve the infection.

If you don't believe that the antibiotic being prescribed is "strong enough," speak with your doctor. This is especially true if you have a new doctor or don't see a doctor all that often.

If you've had recurrent infections in the past for which amoxicillin hasn't helped, let the doctor know. The more your doctor knows about your previous antibiotic use, the better choices he or she can make.

Was this page helpful?

Article Sources

  1. Soukavong M, Kim J, Park K, et al. Signal Detection of Adverse Drug Reaction of Amoxicillin Using the Korea Adverse Event Reporting System Database. J Korean Med Sci. 2016;31(9):1355-61. doi:10.3346/jkms.2016.31.9.1355

  2. Stein GE, Gurwith MJ. Amoxicillin-potassium clavulanate, a beta-lactamase-resistant antibiotic combination. Clin Pharm. 1984;3(6):591-9.

  3. Thomas VM, Thomas-eapen N. An Uncommon Side Effect of a Commonly Used Antibiotic: Amoxicillin-Clavulanic Acid Induced Hepatitis. Korean J Fam Med. 2017;38(5):307-310. doi:10.4082/kjfm.2017.38.5.307

  4. Millard G. Further experience with augmentin in the treatment of skin infections. Scott Med J. 1982;27 Spec No.:S35-8. doi:10.1177/00369330820270S108

  5. Blaser M. Antibiotic overuse: Stop the killing of beneficial bacteria. Nature. 2011;476(7361):393-4. doi:10.1038/476393a

  6. Zaman SB, Hussain MA, Nye R, Mehta V, Mamun KT, Hossain N. A Review on Antibiotic Resistance: Alarm Bells are Ringing. Cureus. 2017;9(6):e1403. doi:10.7759/cureus.1403

Additional Reading

  • 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.