Amoxil substitutes: what to use instead of amoxicillin

Amoxil is a brand name for amoxicillin — a common antibiotic for ear infections, strep throat, sinusitis and some skin infections. But sometimes you need an alternative: you might be allergic, the bug may resist amoxicillin, or the infection type needs a different drug. Here’s a plain guide to common substitutes, when they’re used, and what to watch for.

Common substitutes and when they work

Amoxicillin-clavulanate (Augmentin) — This is often the first switch when simple amoxicillin fails. Clavulanate blocks some resistance enzymes, so it covers bacteria that make penicillinase. It's commonly used for sinus infections, bite wounds, and some chest infections.

Cephalexin (Keflex) — A cephalosporin used for skin infections, some ear infections, and uncomplicated UTIs. If you have a mild penicillin allergy (not anaphylaxis), cephalosporins are often safe, but tell your doctor about any past reactions.

Azithromycin or clarithromycin (macrolides) — These are common when someone is truly allergic to penicillin. They work well for strep throat, certain chest infections, and atypical pneumonia. Know that rising resistance makes them less reliable for some infections.

Clindamycin — A go-to for certain skin and soft-tissue infections, and for severe penicillin allergies. It can cause more digestive upset and raises the risk of Clostridioides difficile (C. diff) diarrhea, so doctors weigh pros and cons carefully.

Doxycycline — Useful for skin infections, some respiratory infections, and acne-related infections. Avoid in pregnant people and children under 8 because it affects bone and teeth development. It’s also a good option where other antibiotics fail or resistance patterns suggest it.

Trimethoprim‑sulfamethoxazole (TMP-SMX) and nitrofurantoin — These aren’t direct substitutes for all Amoxil uses, but they’re often better choices for urinary tract infections. Amoxicillin has poor success for many UTIs due to resistance.

How to pick the right option

Match the drug to the infection. Ear and throat infections, skin infections, UTIs and pneumonia each favor different antibiotics. Your doctor will consider your allergy history, pregnancy status, age, and local resistance trends. When in doubt, they may take a throat or wound swab to guide therapy.

Never self-prescribe. Antibiotics only help bacterial infections. Stopping early or using the wrong drug fuels resistance. If you get side effects like severe rash, trouble breathing, or persistent diarrhea, stop and seek medical help. Talk with your pharmacist if you have drug interactions — for example, macrolides and some heart drugs can mix poorly.

If you want a quick checklist to bring to your appointment: list your allergies (exact reactions), current medications, pregnancy status, recent antibiotic use, and whether symptoms are improving or getting worse. That short list helps your clinician choose a safer, more effective substitute than guessing.