Antibiotic Decision Guide
Which antibiotic is best for your infection?
Select your condition to see recommended first-choice antibiotics and important considerations for your situation.
If you’ve been prescribed Azee - the brand name for azithromycin - you’re probably wondering if there’s a better or cheaper option out there. Maybe your pharmacy ran out. Maybe your insurance won’t cover it. Or maybe you had a bad reaction and want to know what else could work just as well. You’re not alone. Azithromycin is one of the most prescribed antibiotics in the UK, but it’s not the only one, and it’s not always the best fit for every infection.
What Azee (Azithromycin) Actually Does
Azee contains azithromycin, a macrolide antibiotic. It doesn’t kill bacteria outright - it stops them from making proteins they need to grow and multiply. That gives your immune system time to clear the infection. It’s commonly used for chest infections like bronchitis, throat infections like strep throat, ear infections in kids, and some skin infections. It’s also used for sexually transmitted infections like chlamydia.
One big reason doctors choose it is convenience. Most courses last just 3 to 5 days. Some are even a single 1g dose. That’s easier than taking pills four times a day for a week. But convenience doesn’t always mean effectiveness. And it doesn’t mean safety.
Azithromycin can cause stomach upset - nausea, diarrhoea, bloating. In rare cases, it affects heart rhythm, especially if you already have heart problems or take other medications that interact with it. The UK’s MHRA has issued warnings about this, especially for older adults or those with existing heart conditions.
Amoxicillin: The Go-To Alternative for Many
If you’re dealing with a bacterial throat infection, sinusitis, or pneumonia, amoxicillin is often the first choice. It’s a penicillin-class antibiotic. It kills bacteria directly by breaking down their cell walls. That makes it faster-acting than azithromycin in some cases.
Amoxicillin usually needs to be taken three times a day for 7 to 10 days. That’s more inconvenient than Azee’s single dose. But it’s cheaper - often under £5 for a full course on the NHS. It’s also safer for most people, including pregnant women and children. The main downside? If you’re allergic to penicillin, you can’t take it. About 1 in 10 people think they’re allergic, but only 1 in 100 actually are. If you’ve had a rash as a kid but never had trouble breathing or swelling, you might still be able to take it. Ask your doctor for a simple skin test.
For common infections like ear infections in kids or strep throat, amoxicillin is often more effective than azithromycin. A 2023 study in the British Journal of General Practice found that amoxicillin cleared strep throat symptoms 2 days faster on average than azithromycin.
Clarithromycin: The Close Cousin
Clarithromycin is another macrolide, just like azithromycin. In fact, they’re so similar that some doctors switch between them if one doesn’t work. But there are key differences.
Clarithromycin is usually taken twice a day for 7 to 14 days. It’s more likely to cause taste changes - a metallic or bitter taste that can last for days. It also has more drug interactions. If you’re on statins for cholesterol, blood thinners like warfarin, or certain anti-anxiety meds, clarithromycin can raise their levels dangerously. Azithromycin doesn’t do that as much.
On the plus side, clarithromycin is often better for stomach ulcers caused by H. pylori. It’s part of the triple therapy combo with proton pump inhibitors and amoxicillin. Azithromycin isn’t used for that.
If you’ve tried Azee and it didn’t help, clarithromycin might be the next step - but only if your heart is healthy and you’re not on other meds that could clash.
Doxycycline: For When It’s Not a Simple Bug
Doxycycline is a tetracycline antibiotic. It’s broad-spectrum - meaning it works against a wider range of bacteria. That makes it useful for more complex infections.
You’ll take it once or twice a day for 7 to 14 days. It’s often used for acne, Lyme disease, tick-borne illnesses, and some respiratory infections in adults. It’s also used for chlamydia when azithromycin isn’t suitable.
But it’s not for everyone. It can make your skin super sensitive to sunlight. If you’re planning a weekend trip to the park or a beach holiday, you’ll need to avoid sun exposure or wear full protection. It also shouldn’t be taken by children under 12 or pregnant women - it can stain developing teeth and affect bone growth.
It’s cheaper than Azee in the UK, often under £7 for a course. And unlike azithromycin, it’s not linked to heart rhythm issues. But it needs to be taken on an empty stomach - no food, milk, or antacids for an hour before and after. That’s harder to stick to than Azee’s flexible dosing.
Levofloxacin and Ciprofloxacin: Stronger, But Riskier
These are fluoroquinolones - powerful antibiotics reserved for serious infections. You’ll only get them if simpler options have failed, or if you have a severe pneumonia, kidney infection, or complicated UTI.
They work fast. But they come with serious risks. The FDA and MHRA have issued black box warnings about tendon rupture, nerve damage, and mental health side effects like anxiety and hallucinations. These risks are higher in people over 60, those on steroids, or with kidney problems.
Levofloxacin is usually taken once a day. Ciprofloxacin, twice. Both cost more than Azee - around £15 to £20 on private prescription. They’re not first-line for throat or ear infections. Use them only when absolutely necessary.
When Azee Is the Best Choice
Just because there are alternatives doesn’t mean Azee isn’t the right one. Here’s when it still wins:
- You have a penicillin allergy and need an oral antibiotic for strep throat or sinusitis.
- You need a short course - like a 3-day treatment for chlamydia.
- You struggle to remember to take pills multiple times a day.
- You’re being treated for a community-acquired pneumonia where guidelines recommend it.
For chlamydia, azithromycin remains the gold standard. The UK’s National Institute for Health and Care Excellence (NICE) still recommends a single 1g dose as first-line treatment. Alternatives like doxycycline are second-choice.
What to Do If Azee Doesn’t Work
Antibiotics don’t always work - not because they’re weak, but because:
- The infection is viral (like most colds or flu), and antibiotics do nothing.
- The bacteria are resistant - common with overuse.
- You didn’t finish the course, even if you felt better.
If your symptoms don’t improve after 2-3 days, or get worse, see your GP. Don’t just switch to another antibiotic on your own. That can make resistance worse.
Your doctor might do a throat swab, urine test, or blood test to confirm what’s causing the infection. That’s how they pick the right antibiotic - not guess.
Cost and Availability in the UK
On the NHS, azithromycin (including Azee) is free for those eligible. Private pharmacies charge around £12-£18 for a 5-day course. Amoxicillin is £2-£5. Doxycycline is £7-£10. Clarithromycin is £8-£12. Levofloxacin can be £15-£25.
Brand names like Azee cost more than generic azithromycin. But they’re the same drug. Ask your pharmacist if you can switch to the generic version. You’ll save money with no loss in effectiveness.
Final Decision Guide
Here’s a simple way to think about it:
| Condition | Best First Choice | Good Alternative | Avoid |
|---|---|---|---|
| Strep throat | Amoxicillin | Azithromycin (if allergic to penicillin) | Doxycycline, fluoroquinolones |
| Chlamydia | Azithromycin (1g single dose) | Doxycycline (100mg twice daily for 7 days) | Clarithromycin |
| Ear infection (child) | Amoxicillin | Azithromycin (if allergic) | Fluoroquinolones |
| Acne or Lyme disease | Doxycycline | Azithromycin (sometimes) | Amoxicillin |
| Severe pneumonia | Amoxicillin + clarithromycin | Levofloxacin | Only azithromycin alone |
There’s no single ‘best’ antibiotic. The right one depends on what you’re treating, your medical history, allergies, age, and other meds you take.
Is Azee the same as azithromycin?
Yes. Azee is just a brand name for the antibiotic azithromycin. The active ingredient is identical. Generic azithromycin works the same way and costs less. Your pharmacist can switch you to the generic version unless your doctor specifically asked for the brand.
Can I switch from Azee to amoxicillin if I run out?
Only if your doctor says so. Azee and amoxicillin treat different types of bacteria. Switching on your own could mean the infection doesn’t clear, or worse - it could become resistant. Always check with your GP before changing antibiotics.
Why does my doctor sometimes prescribe azithromycin and sometimes amoxicillin?
It depends on the infection. Amoxicillin is better for common bacterial infections like strep throat or ear infections. Azithromycin is used when you’re allergic to penicillin, need a short course, or are treating chlamydia. Doctors choose based on guidelines, your history, and what’s most likely causing your symptoms.
Do azithromycin alternatives have fewer side effects?
It varies. Amoxicillin usually causes less heart-related risk but can cause diarrhoea or rash. Doxycycline causes sun sensitivity. Clarithromycin affects taste and interacts with many drugs. Azithromycin has a small risk of heart rhythm changes. No antibiotic is side-effect-free. The best choice is the one that matches your health profile.
Can I take azithromycin if I have a heart condition?
It depends. If you have a history of irregular heartbeat, low potassium or magnesium, or are on certain heart medications, azithromycin may not be safe. Your doctor will check your ECG and medication list before prescribing it. If there’s risk, they’ll pick an alternative like amoxicillin or doxycycline.
Next Steps
If you’re unsure which antibiotic is right for you, don’t guess. Keep a list of your symptoms, how long they’ve lasted, and any past reactions to antibiotics. Take it to your GP. Ask: "Is this infection bacterial? What’s the most targeted option? Are there cheaper or safer alternatives?"
Antibiotics save lives - but only when they’re used correctly. Choosing the right one isn’t about what’s newest or most convenient. It’s about matching the drug to the bug, your body, and your life.
just took azee for my sinus thing and wow it was a breeze - one pill a day for 3 days and boom done. no need to be a human calendar like with amoxicillin. also cheaper than my coffee habit. why do people make this so complicated?