Amoxicillin vs. Levaquin (Strength and Effectiveness)

  • Medical Reviewer: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Amoxicillin vs.Levaquin quick comparison

What is amoxicillin? What is Levaquin? How do they work?

Amoxicillin (Amoxil) is used to treat bacterial infections. It belongs to a class of antibiotics called penicillins. Other members of this class include ampicillin (Unasyn), piperacillin (Pipracil), ticarcillin (Ticar), and several others.

Levaquin (levofloxacin) is an antibiotic used for treating bacterial infections. It works by stopping multiplication of bacteria by preventing the reproduction and repair of their genetic material (DNA). Levaquin is in a class of antibiotics called fluoroquinolones. Other antibiotics in this class of drugs include ciprofloxacin (Cipro), norfloxacin, (Noroxin), ofloxacin (Floxin), trovafloxacin (Trovan), lomefloxacin (Maxaquin), gatifloxacin (Tequin), and moxifloxacin (Avelox).

What are the uses of amoxicillin vs. Levaquin?

Amoxicillin uses

Amoxicillin is used to treat infections due to bacteria that are susceptible to the effects of amoxicillin.
Common bacterial infections that amoxicillin is used for include infections of the

Amoxicillin also treats gonorrhea.

Levaquin uses

  • Levaquin is used to treat infections of the sinuses, skin, lungs, ears, airways, bones, and joints caused by susceptible bacteria.
  • Levaquin also is frequently used to treat urinary infections, including those resistant to other antibiotics, as well as prostatitis (infection of the prostate).
  • Levaquin is effective in treating infectious diarrhea caused by E. coli, Campylobacter jejuni, and Shigella bacteria.
  • Levaquin also can be used to treat various obstetric infections, including mastitis (infection of the breast).
  • Inhalation anthrax exposure also is treated with Levaquin.

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What are the side effects of amoxicillin vs. Levaquin?

Amoxicillin side effects

People who are allergic to the cephalosporin class of antibiotics, which are related to the penicillins, for example, cefaclor (Ceclor), cephalexin (Keflex), and cefprozil (Cefzil), may or may not be allergic to penicillins.

Serious but rare reactions include:

Amoxicillin can alter the normal bacteria in the colon and encourage overgrowth of some bacteria such as Clostridium difficile, which causes inflammation of the colon (pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting amoxicillin (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.

Levaquin side effects

Serious side effects and warnings include:

  • Levaquin as well as other antibiotics in the fluoroquinolone class of antibiotics, has been associated with tendinitis and even rupture of tendons, particularly the Achilles tendon.
  • Fluoroquinolones have neuromuscular blocking activity and can worsen muscle weakness in individuals with myasthenia gravis.

The most frequently reported side effects are:

Less common side effects include:

  • Difficulty sleeping
  • Dizziness
  • Abdominal pain
  • Rash
  • Abdominal gas
  • Itching

Rare allergic reactions have been described are:

Possible serious side effects of Levaquin include:

Other serious side effects and adverse events of Levaquin include:

  • Levaquin should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving Levaquin.
  • Levaquin should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.
  • Many antibiotics, including Levaquin, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon, (C. difficile or pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting Levaquin (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.
  • Patients taking Levaquin can develop sensitivity of the skin to direct sunlight (photosensitivity) and should avoid exposure to sunlight or use sunblock.
  • Fluoroquinolones worsen low blood glucose levels when combined with sulfonylureas (for example, glyburide [Micronase, Diabeta, Glynase, Prestab]).
  • Because of serious side effects associate with fluoroquinolones, they should not be used for treating uncomplicated urinary tract infections, acute bacterial exacerbation of chronic bronchitis or acute bacterial sinusitis unless there are no other alternatives.

What is the dosage of amoxicillin vs. Levaquin?

Amoxicillin dosage instructions

  • For most infections in adults the dose of amoxicillin is 250 mg every 8 hours, 500 mg every 8 hours, 500 mg every 12 hours or 875 mg every 12 hours, depending on the type and severity of infection.
  • For the treatment of adults with gonorrhea, the dose is 3 g given as one dose.
  • For most infections, children older than 3 months but less than 40 kg are treated with 25 or 45 mg/kg/day in divided doses every 12 hours or 20 or 40 mg/kg/day with one-third of the daily dose given every 8 hours depending on the type and severity of the infection.
  • Amoxicillin can be taken with or without food.

Levaquin dosage instructions

  • The usual dose is 250-750 mg given once daily for 3-14 days depending on the type of infection.
  • Anthrax is treated with 500 mg daily for 60 days.
  • It is important to take oral formulations at least 2 hours before or 2 hours after any antacid or mineral supplement containing iron, calcium, zinc, or magnesium since these bind Levaquin and prevent its absorption into the body.

What are the drug interactions of amoxicillin vs. Levaquin?

Amoxicillin is rarely associated with important drug interactions.

Levaquin drug interactions

  • Iron, calcium, zinc, or magnesium can attach to Levaquin and other fluoroquinolones and prevent their absorption from the intestine into the blood. Therefore, products (for example, antacids) that contain iron, calcium, zinc or magnesium should be taken at least 2 hours before or 2 hours after Levaquin. Other drugs that contain these minerals and can similarly interact with Levaquin include sucralfate (Carafate) and didanosine (Videx, Videx EC).
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs) with Levaquin may increase the risk of CNS stimulation, resulting in over-excitation. There have been reports of changes in blood sugar (increases and decreases) in patients treated with fluoroquinolones and antidiabetic agents.
  • Fluoroquinolones may increase the effect of warfarin (Coumadin, Jantoven).

Are amoxicillin and Levaquin safe to take if I'm pregnant or breasfeeding?

Amoxicillin safety

Penicillins are generally considered safe for use by pregnant women who are not allergic to penicillin.

Small amounts of amoxicillin may be excreted in breast milk and may cause diarrhea or allergic responses in nursing infants. Amoxicillin is generally considered safe to use while breastfeeding. Amoxicillin is used to treat infections in the newborn.

Levaquin safety

Levaquin is not recommended for use in pregnant women since Levaquin causes joint and bone deformities in juvenile animals of several species.
Levaquin is excreted in breast milk. Mothers should decide whether to stop breastfeeding or discontinue Levaquin.

REFERENCES:

FDA Prescribing Information for amoxicillin.
<https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020634s068,020635s074,021721s035lbl.pdf>

FDA Prescribing Information for Levaquin®.
<https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020634s068,020635s074,021721s035lbl.pdf>

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Summary

Amoxicillin and Levaquin are antibiotics used to treat various bacterial infections of the throat, lungs, skin, prostate, and bladder. Amoxicillin is a penicillin while Levaquin belongs to a class of antibiotics called fluoroquinolones. Penicillins and fluoroquinolones work differently in killing bacteria. Both drugs have similar side effects, for example, abdominal pain, headache, rash, itching, insomnia, diarrhea, nausea, and vomiting.

Amoxicillin also causes side effects that include easy bruising, heartburn, insomnia, confusion, bleeding, and dizziness.

Levaquin has serious side effects, for example, sun sensitivity, low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), abnormal heart beats, liver problems, C. diff associated diarrhea.

Dosage depends upon the drug and type of infection. Amoxicillin has few drug interactions while Levaquin interacts with certain mineral supplements, nonsteroidal anti-inflammatory drugs (NSAIDs), and blood thinners like warfarin (Coumadin, Jantoven). Neither drug is recommended to take if you are pregnant or breastfeeding.

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Reviewed on 10/30/2017
References
REFERENCES:

FDA Prescribing Information for amoxicillin.
<https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020634s068,020635s074,021721s035lbl.pdf>

FDA Prescribing Information for Levaquin®.
<https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020634s068,020635s074,021721s035lbl.pdf>

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